Introduction: Fournier's Gangrene consists of multi-bacterial rapid progression infection, involving genital, abdominal, and perineal region, promoting affected tissue necrosis. Considered a public health problem, compromises the patient life quality, and has high mortality coefficients.Objective: Analyzing in the literature the therapeutic measures in patients diagnosed with Fournier's Gangrene. Method:Integrative review from productions picked up in LILACS, IBECS, MEDLINE, PUBMED, and CUMED databases in the period 2005 to 2015. Fournier's Gangrene, Prevalence and Therapy descriptors in English and Portuguese were used. The search amounted to 765 productions, of which 17 were included as a sample for this study. Results:The analysis regarding the publications enabled the construction of two thematic categories: demographic, epidemiological and clinical aspects of patients diagnosed with Fournier's Gangrene and the therapeutic modalities in treating Fournier's Gangrene. It was observed that the disease is prevalent in males, elderly, and people with diabetes mellitus. The treatment is based on antibiotics, surgical debridement, and skin reconstruction for the affected areas. Conclusion:The diagnosis, assessment and multidisciplinary early intervention are essential to ensure proper treatment and life maintenance. 5 Principal author, year, country and journal Delineation, sample and database Results and conclusion Carvalho JP [16]; 2007; Brazil; International Brazilian journal of urology Retrospective, descriptive and quantitative; N= 80; MEDLINE All patients performed scrotum and perineal region debridement. Fournier's Gangrene is a severe pathology that should be treated aggressively with debridement and surgical reconstruction of the involved regions. Omisanjo AO [17]; 2014; Nigeria; Annals of African medicine Retrospective, descriptive and quantitative; N = 11; MEDLINE All patients were male. They were submitted late to hospital environment, however, through aggressive and appropriate treatment, it was possible to minimize morbidity and mortality caused by this injury. Chinchillaa RM [18]; 2009; Spain; Actas urologicas españolas Observational, retrospective, descriptive, quantitative; N=20; PUBMED It was predominant in the masculine gender with 61-year average age. The main predisposing factor was DM, the average time of hospitalization was 25.7 days, and general mortality rate was 10%. Early diagnosis and appropriate multidisciplinary and aggressive intervention are essential for proper recovery. Medina PJ [19]; 2008; Spain; Actas urologicas españolas Retrospective, descriptive and quantitative; N=90; IBECS One noted mortality rate -34.4% -in patients with an average age -63.0 years. Comorbidities found in 51 patients, being the main DM. Patient's age and presence of risk factors have an impact on the disease prognosis. Sámano VL [20]; 2007; Spain; Archivos españoles de urología Transversal, retrospective, and tivo descriptive; N=40; IBECS Patients were 21 and 93-year old, predominantly males (97.5%). The mos...
We present a case of a 60-year-old male with poorly controlled type 2 Diabetes that had recurrent prosthetic knee infection that besides antibiotic or surgical treatment was difficult to treat. On the latest revision, he presented with an infection of the knee spacer with severe stiffness impairing knee flexion. In the debridement phase, we noticed a nidus of purulent tissue on the quadriceps tendon hidden inside an apparently normal peritendon. This case highlights several management details to avoid recurrent catastrophic prosthetic knee infection recurrence such as: the importance of perioperative management of comorbid diseases such as hyperglycaemia and poorly controlled diabetes that are a well-defined evidence-based risk factor for prosthetic joint infection and also the importance of adequate debridement as a balanced surgical gesture between excising too little or too much not to damage the soft tissue envelope.
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