Fournier's Gangrene: A Review and Outcome Comparison from 2009 to 2016

Ferretti, Mark; Saji, Akhil; Phillips, John L.

doi:10.1089/wound.2017.0730

Cited by 25 publications

(32 citation statements)

References 17 publications

(35 reference statements)

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“…The authors from urology clinics reported the rate of females as 0-5% in their studies. [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: 87%

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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: 87%

“…[4] Since this description of Fournier, the classical patient profile has been changed. [5] Fournier's gangrene has been shown to be associated with several comorbidities and affects both genders, either young patients or elder ones as well.…”

mentioning

confidence: 99%

Fournier’s Gangrene: Review of 36 Cases

Çalışkan

Özsoy

Sungur

et al. 2019

Ulus Travma Acil Cerrahi Derg

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“…The mortality rates decreased after the early diagnosis of FG and treatment with more radical methods, and the main concern became prolonged LOS [5]. There are studies reporting that numerous parameters such as increased age, BMI, smo-▶ king, presence of comorbidity, FGSI score, urinary or fecal diversion, use of HBOT and NPWT are significant for mortality [5,23,24]. In a 43,146 series scan, Furr et al found that the most important predictors of LOS were complex wound repair and urinary or fecal diversion [5].…”

Section: Discussionmentioning

confidence: 99%

Factors affecting length of stay in Fournier’s gangrene: a retrospective analysis of 10 years’ data

et al. 2020

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Background We aimed to investigate the parameters that have an effect on the length of stay and mortality rates of patients with Fournier’s gangrene. Material and Methods A retrospective review was performed on 80 patients who presented to the emergency department and underwent emergency debridement with the diagnosis of Fournier’s gangrene between 2008 and 2017. The demographic and clinical characteristics, length of stay, Fournier’s Gangrene Severity Index score, cystostomy and colostomy requirement, additional treatment for wound healing and the mortality rates of the patients were evaluated. Results Of the 80 patients included in the study, 65 (81.2 %) were male and 15 (18.7 %) female. The most common comorbidity was diabetes mellitus. The mean time between onset of complaints and admission to hospital was 4.6 ± 2.5 days. As a result of the statistical analyses, it was found that Fournier’s Gangrene Severity Index score, hyperbaric oxygen therapy, negative pressure wound therapy and the presence of sepsis and colostomy were significantly positively correlated with length of stay. Also it was found that the Fournier’s Gangrene Severity Index score, administration of negative pressure wound therapy and the presence of sepsis were correlated with mortality. Conclusion Fournier’s gangrene is a mortal disease and an emergency condition. With the improvements in Fournier’s gangrene disease management, mortality rates are decreasing, but long-term hospital stay has become a new problem. Knowing the values predicting length of stay and mortality rates can allow for patient-based treatment and may be useful in treatment choice.

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“…Based on 20 FG cases at their institution, Ferretti et al . reported the possibility of decreased hospital stays in FG patients treated with HBO . The two studies described above usually had standard management, such as administration of broad‐spectrum antibiotics and prompt surgical debridement.…”

Section: Fgmentioning

confidence: 99%

Potential of hyperbaric oxygen in urological diseases

et al. 2019

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Abbreviations & Acronyms AKI = acute kidney injury Alum = aluminium potassium sulfate ATA = atmosphere absolute CR = complete response CRPC = castration-resistant prostate cancer DC = dystrophic calcification EMT = epithelial-tomesenchymal transition FG = Fournier gangrene FGSI = Fournier Gangrene Severity Index HA = hyaluronic acid HBO = hyperbaric oxygen HIC = Hunner type interstitial cystitis IC/PBS = interstitial cystitis/painful bladder syndrome NHIC = non-Hunner type interstitial cystitis PR = partial response RHC = radiation-induced hemorrhagic cystitis ROS = reactive oxygen species RT = radiation therapy TRP = transient receptor potential channel WF10 = immunokine Correspondence: TomoakiAbstract: Hyperbaric oxygen therapy is a promising medical technology that delivers oxygen to targeted tissues at high pressure to increase the amount of dissolved oxygen in the blood. Over the past three decades, hyperbaric oxygen has been used in a variety of conditions, including radiation-induced tissue injuries, non-healing states with ischemia and malignant neoplasms. In the field of urology, hyperbaric oxygen has also been applied to some pathological conditions (e.g. radiation-induced hemorrhagic cystitis, Fournier gangrene, interstitial cystitis, male infertility, acute kidney injury and urological cancers). In normal and injured tissues, hyperoxia from hyperbaric oxygen therapy contributes to anti-inflammation, angiogenesis through endothelial proliferation, enhanced fibroblastic activity, increased lymphocyte and macrophage activity, and bactericidal effects with the aim of wound repair. In cancerous tissues, the enhanced supply of oxygen into the hypoxic cancer cells can exert inhibitory effects on factors that contribute to their aggressiveness (e.g. cell survival, escape from apoptosis, epithelial-to-mesenchymal transition and tumor immunotolerance), and sensitize the tumor to radiation therapy and chemotherapy. However, further research, including multicenter clinical studies, is essential for determining the role of hyperbaric oxygen therapy in refractory urological diseases that are resistant to conventional therapies.

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Fournier's Gangrene: A Review and Outcome Comparison from 2009 to 2016

Cited by 25 publications

References 17 publications

Fournier’s Gangrene: Review of 36 Cases

Fournier’s Gangrene: Review of 36 Cases

Factors affecting length of stay in Fournier’s gangrene: a retrospective analysis of 10 years’ data

Potential of hyperbaric oxygen in urological diseases

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