Fournier’s gangrene: A retrospective analysis of 25 patients

Yücel, Metin; Özpek, Adnan; Başak, Fatih; Kılıç, Ali; Ünal, Ethem; Yuksekdag, Sema; Acar, Aylin; Baş, Gürhan

doi:10.5505/tjtes.2017.01678

Cited by 28 publications

(59 citation statements)

References 18 publications

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“…[5,10] In contrast, studies from the other clinics reported that the female patients composed 56% and 28.8% of the whole patients. [9,11] In our study, the mean age of the patients was 59 years, and 97% of the patients were male.…”

Section: Discussionmentioning

confidence: 61%

“…[7] Fournier's gangrene is frequently diagnosed in males, but it may affect both genders in every age groups. [9] The reason for the lower prevalence in female patients can be explained by the simple drainage of the female perineum through the vaginal way. Another reason for the low prevalence in women is that most of the articles were reported by urology clinics, which led to males being overreported.…”

Section: Discussionmentioning

confidence: 99%

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Fournier’s Gangrene: Review of 36 Cases

Çalışkan

Özsoy

Sungur

et al. 2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Fournier's gangrene (FG) is a very rare disease in daily urological practice. Despite medical improvements, mortality in FG is still high. Early diagnosis is very important to reduce additional instrumentations and mortality. In this study, we aimed to present the characteristics of the patients with Fournier's gangrene followed in two centers during ten years period. METHODS: The medical records of patients with FG were reviewed retrospectively. The patient characteristics, causative pathogens, laboratory findings and treatment modalities were evaluated. RESULTS: A total of 36 FG cases admitted between January 2008 and February 2018 were included in this study, consisting of 35 male patients, and one female patient with a mean age of 59.27±12.91 years. The mean duration of hospital stay was 19±10.44 days. The most common predisposing factor was diabetes mellitus, which was found in 28 patients. Malignancy was detected in three patients; prostate cancer in two patients and chronic lymphoblastic leukemia in one patient. Two patients had liver cirrhosis, and one patient had Behcet's disease and psoriasis. The microbiological agent was isolated from a wound culture in nine patients. After urgent surgical debridement, daily dressing with nitrofurazone (Furacin) was done. Additional debridement was conducted when necessary. Orchiectomy was performed in 10 patients; two of them underwent bilateral orchiectomy. One patient died because of sepsis on the seventh day of hospital admission. CONCLUSION: FG is a life-threatening urological emergency with a high mortality rate. Treatment with broad-spectrum antibiotics and urgent surgery is pivotal for the prevention of mortality.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Fournier’s Gangrene: Review of 36 Cases

Çalışkan

Özsoy

Sungur

et al. 2019

Ulus Travma Acil Cerrahi Derg

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“…Fournier's gangrene is known to be a rapid onset disease, but studies have shown that application to the hospital is delayed by an average of one week after initial symptoms have presented. [13] In our study, the median time from symptom onset to hospital application was four (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) days. Immediate diagnosis and treatment of FG are known to affect prognosis.…”

Section: Discussionmentioning

confidence: 67%

“…The age of the patients hospitalized in the intensive care unit (ICU) was found to be higher than the patients who did not require ICU admittance (65.33±11.63 years vs. 54.39±11.79 years, respectively; p=0.013). Median FGSI score was 2 (0-14), while the median UFGSI score was 4 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Median FGSI and UFGSI scores were found to be higher in patients accepted to the ICU compared to those who were not (4 vs. 2, p=0.025; and 6 vs. 3, p=0.002, respectively).…”

Section: Resultsmentioning

confidence: 99%

“…[7] Radiological techniques (e.g., ultrasonography, computed tomography, and magnetic resonance imaging) aid physicians in the assessment of the condition, while physical examination and anamnesis are crucial for the diagnosis of FG. [8][9][10][11] The most common symptoms of FG include scrotal pain, swelling and erythema. Systemic symptoms, such as fever, rigor and tachycardia, are often present.…”

Section: Discussionmentioning

confidence: 99%

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Fournier’s Gangrene: Five Years’ Experience from a Single Center in Turkey

Hatipoğlu¹

2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Is the present study aims to analyze demographic, clinical and surgical data of all patients with FG (Fournier's gangrene) admitted to a tertiary healthcare hospital in the largest city of Turkey. METHODS:This study included 35 patients with Fournier's gangrene, who were followed by the General Surgery, Plastic Surgery, clinical data, including gender, age, length of stay at the hospital, the underlying cause(s), number of debridement, predisposing factors, and surgical reconstructive data over 10 years were assessed and analyzed retrospectively. RESULTS:The mean age of the 35 patients was 58.14±12.71 years. Diabetes mellitus was present in 20 of the 35 (57.1%) patients. Twelve of the patients (34.2%) were hospitalized in the intensive care unit (ICU). Length of stay in the ICU was found to be significantly influenced by age, hematocrit level, FGSI and UFGSI (p=0.013, p=0.030 p=0.025 and p=0.002, respectively). CONCLUSION:Fournier's gangrene is a fulminant infection with a high mortality rate. Physical examination and anamnesis are quite important for the diagnosis of FG. DM is the most common comorbidity. Age, hematocrit level, FGSI and UFGSI scores affect the patients' length of stay in the ICU.

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The role of vacuum-assisted closure (VAC) therapy in the management of FOURNIER’S gangrene: a retrospective multi-institutional cohort study

et al. 2020

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Purpose To explore the role of vacuum assisted closure (VAC) therapy versus conventional dressings in the Fournier's gangrene wound therapy. Patients and Methods This is a retrospective multi-institutional cohort study. Data of 92 patients from nine centers between 2007 and 2018 were retrospectively analyzed. After surgery, patient having a local or a disseminated FG were managed with VAC therapy or with conventional dressings. The 10-weeks wound closure cumulative rate and OS were analyzed. Results Of the 92 patients, 62 (67.4%) showed local and 30 (32.6%) a disseminated FG. After surgery, 19 patients (20.7%) with local and 14 (15.2%) with disseminated FG underwent to VAC therapy; 43 (46.7%) with local and 16 (17.4%) with disseminated FG were treated using conventional dressings. The multivariable logistic regression analysis demonstrated that the VAC in patients with disseminated FG led to a higher cumulative rate of wound closure than patients treated with no-VAC (OR = 6.5; 95% CI 1.1-37.4, p = 0.036). The Kaplan-Meier survival curves for the OS showed a significant difference between no-VAC patients with local and disseminated FG (OS rate at 90 days 0.90, 95% CI 0.71-0.97 vs 0.55, 95% CI 0.24-0.78, respectively; p = 0.039). Cox regression confirmed that no-VAC patients with disseminated FG showed the lowest OS (hazard ratio adjusted for sex and age HR = 3.4, 95% CI 1.1-10.4; p = 0.033). Conclusions In this large cohort study, VAC therapy in patients with disseminated FG may offer an advantage in terms of 10-weeks wound closure cumulative rate and OS at 90 days after initial surgery.

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Fournier’s gangrene: A retrospective analysis of 25 patients

Cited by 28 publications

References 18 publications

Fournier’s Gangrene: Review of 36 Cases

Fournier’s Gangrene: Review of 36 Cases

Fournier’s Gangrene: Five Years’ Experience from a Single Center in Turkey

The role of vacuum-assisted closure (VAC) therapy in the management of FOURNIER’S gangrene: a retrospective multi-institutional cohort study

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