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06-17-2009, 06:19 AM
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Farm Accident
Case report A 28-year-old man was working on a farm and suffered injury when he stepped over a power take-off (PTO) shaft from which the safety guard had been removed. He caught his coat in the PTO shaft and was pulled into the machinery, resulting in the degloving of his genital and perineal regions. At the scene of the accident, the patient was awake, alert, and oriented to person, place, and time. He was transported by helicopter to Saint Louis University Hospital. Physical examination revealed complete degloving of an area that measured 9 x 20 cm and encompassed the penile shaft, scrotum, and perineal region to the anal sphincter. The transporters had established hemostasis of the region with gauze, and the patient’s red blood cell count was within normal limits upon arrival to the hospital. His urethra appeared undamaged on retrograde urethrography, and an 18-French Foley catheter was placed for urinary diversion (Figure 1). |