What is the proper care for a scrotal wound?

From the Guidelines

Proper care for a scrotal wound involves immediate gentle cleaning, application of antiseptic solution, and coverage with a sterile dressing, with consideration for early surgical debridement in cases of severe infection like Fournier’s gangrene, as recommended by the 2018 WSES/SIS-E consensus conference 1. When managing a scrotal wound, it is essential to prioritize gentle cleaning with mild soap and warm water, followed by patting the area dry with a clean towel. Applying an antiseptic solution like povidone-iodine or chlorhexidine can help prevent infection. The wound should be covered with a sterile, non-stick dressing and secured with medical tape or supportive underwear. Key considerations in scrotal wound care include:

• Daily dressing changes or whenever the dressing becomes wet or soiled
• Use of over-the-counter pain relievers like acetaminophen or ibuprofen for pain and swelling management
• Monitoring for signs of infection, such as increasing pain, redness, swelling, pus, or fever, which may necessitate immediate medical attention
• Recognition of the potential for significant swelling and bruising due to the scrotum's rich blood supply In severe cases, such as Fournier’s gangrene, early and extensive initial surgical debridement is crucial, as it improves survival, according to the 2018 WSES/SIS-E consensus conference recommendations 1. Additionally, consideration for fecal diversion, either by colostomy or fecal tube system with or without negative pressure therapy, may be necessary in cases with fecal contamination, as suggested by the same conference 1.

From the Research

Scrotal Wound Care

Proper care for a scrotal wound is crucial to prevent infection and promote healing. The following are some key points to consider:

• Cleaning and dressing the wound: The wound should be cleaned with saline solution and dressed with a sterile bandage to prevent infection 2.
• Use of topical antibiotics: Topical antibiotics such as bacitracin zinc and neomycin sulfate can help prevent infection in uncomplicated soft-tissue wounds 2.
• Monitoring for signs of infection: It is essential to monitor the wound for signs of infection, such as redness, swelling, and increased pain 3, 4.
• Surgical intervention: In some cases, surgical intervention may be necessary to drain an abscess or debride necrotic tissue 5, 3.

Prevention of Infection

To prevent infection, the following measures can be taken:

• Use of antimicrobial prophylaxis: Antimicrobial prophylaxis can help prevent surgical site infection (SSI) after urological scrotal and inguinal surgical procedures 4.
• Keeping the wound clean and dry: Keeping the wound clean and dry can help prevent infection 2.
• Avoiding tight clothing: Avoiding tight clothing can help reduce irritation and promote healing 3.

Complications

Scrotal wounds can lead to complications such as:

• Abscess formation: Abscess formation can occur as a result of infection 5.
• Gangrene: Gangrene can occur if the wound becomes infected and is not properly treated 3.
• Surgical site infection: Surgical site infection can occur after urological scrotal and inguinal surgical procedures 4.