Iranian Journal of Pediatric Surgery

Vol. 12 No. 1 (2026)

Perineal Trauma in Female Children: Unveiling the Secrets to Healing Delicate Wounds

Iranian Journal of Pediatric Surgery, Vol. 12 No. 1 (2026), 20 May 2026 , Page 40 - 58
https://doi.org/10.22037/irjps.v12i1.51341

Abstract

Introduction: Perineal trauma in female children presents unique diagnostic and therapeutic challenges due to its relative rarity, varied modes of injuries, psychosocial implications and diverse presentation patterns. This study aims to analyze the management strategies based on grade of injuries and outcomes compared with contemporary literature.

 

Materials and Methods:  A retrospective analysis was conducted on female patients (age <12 years) presenting to our institute with perineal trauma between January 2021 and December 2024. Injuries were graded using the Genital Injury Score (GIS). Primary outcomes included wound healing, functional recovery, and complications. A systematic literature review was performed.

 

Results:  Nineteen patients (mean age 6.32 years) were included. Primary etiologies were straddle injuries (falls from height) (42.1%) followed by sexual assault (36.84%). Grade III injuries predominated (47.4%), most commonly presenting with vaginal bleeding (73.68%). Primary closure using absorbable sutures was successful in 89% of cases. One patient (5.2%) required temporary diversion colostomy and one was referred with sigmoid colostomy. Mean follow-up was 6.2 months (range: 3-12). One patient (5.2%) experienced early post-operative bleeding requiring re-suturing. No cases of permanent fecal or urinary incontinence were recorded.

  

Conclusion: Early examination under anesthesia and systematic injury grading are crucial for optimal outcomes

 in perineal trauma in female children. Primary closure yields excellent results in most cases even in higher grades of injuries with selective use of fecal diversion. A standardized management protocol based on injury grade improves outcomes.

 

Keywords:
  • perineal trauma
  • Trauma
  • Paediatric Trauma
  • Examination under anesthesia (EUA)
  • Sexual abuse

How to Cite

Joleya, D. M. K., Tiwari, D. P., Shukla, D. R. M., Raj, D. V., Ladda, D. A., Sharma, D. S. S., … Joshi, D. M. (2026). Perineal Trauma in Female Children: Unveiling the Secrets to Healing Delicate Wounds. Iranian Journal of Pediatric Surgery, 12(1), 40–58. https://doi.org/10.22037/irjps.v12i1.51341

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