Considered one of the most severe types of trauma with a high impact upon patient survival, burns are the leading cause of disability-adjusted life-years (DALYs), and are responsible for high morbidity, prolonged hospitalization, disfigurement and social stigma. Of particular interest are injuries that affect the functional areas: face, neck, hand and fingers, joints, feet and soles and perineum. Burns to these regions highly influence the day-to-day activities of patients due to the formation of vicious scars and contractures, which may affect both quality of life and functional capacity. One of the primary challenges in the management of burn patients is the effective coverage of tissue defects resulting from such injuries. Cases that have a large area of burned surface also have a limited amount of total available skin. As such, the importance of skin substitutes increases, particularly in the treatment of these areas. Skin substitutes are widely utilized in plastic surgery due to their ability to promote wound healing by providing an extracellular matrix. Consequently, ongoing research has focused on developing skin substitutes that can serve as alternatives to autografts, addressing the challenges associated with large-scale tissue loss. This article aims to present and compare the most used skin substitutes, highlighting their respective advantages and limitations. This topic continues to be a subject of significant debate, as an ideal substitute has yet to be created. The cost–efficiency ratio is a practical consideration that must be tailored to each specific medical system. The available data in the literature usually present general guidelines, not rules, and as such, they need to be adapted to each patient’s necessities.

Background and Objectives: Burn injury represents a very important public health problem that affects all age groups. Of all burns, of particular interest is that of the perineum. Despite the importance of the subject, unfortunately, the medical literature on this anatomical region is sparse. With this study we aim to analyze the characteristics of burns affecting the perineal area, the physiopathologic implications of this injury, the influence of patient prognosis, possible complications and therapeutic guidelines. Materials and Methods: This study is formed by a retrospective analysis of cases that were admitted over a period spanning 3 years with a total of 258 burned patients. After inclusion criteria, we selected 49 patients who had perineal burns and compared this group to a non-perineal burns lot of 198 patients (11 were excluded). We studied their characteristics and the demographical aspects that we deemed most important to their condition: age, sex, burn percentage of total body surface area (TBSA), the percentage of third-degree lesions, comorbidities, and associated infections, inhalation injuries and we calculated the significant scores such as the Abbreviated Burn Severity Index score (ABSI). Results: The patients in our study mostly had severe extensive burns (64.9% mean TBSA) which were also underlined by the mean ABSI of 10.88 ± 2.46 thus having a poor prognosis considering their age, the percentage of burned area, the presence of third-degree burns and inhalation injuries. In our study, perineal burns were usually associated with burns of adjacent regions abdominal wall burns comprising 51% and thigh burns comprising 97.9% of the associated injuries. This relationship both explains their presence in mostly severe cases with higher TBSA and also underlines the issues that derive from the burns of the perineum and their several complications which lead to an unbalance of the patients. The treatment of perineal burns still remains much debated in the literature when considering their indications and can become rather complex in the sequelae setting. Conclusions: The issue of burns remains one of the most important subjects in plastic surgery. Being a region hard to treat but with a big influence on patient evolution and survival chances prevention remains a key factor.