Fournier???s Gangrene: A Review of 43 Reconstructive Cases

Ferreira, Pedro; Reis, Jorge; Amarante, José; Silva, Álvaro Catarino; Pinho, Carlos; Oliveira, Isabel; Silva, Pedro Natividade da

doi:10.1097/01.prs.0000244925.80290.57

Cited by 128 publications

(161 citation statements)

References 32 publications

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“…2 One reason might be the younger patient collective and lower rate of co morbidities compared to other studies. 17 McHenry et al 18 found a lower mortality rate in patients with necrotizing fasciitis, who where treated within 25 h after admission.…”

Section: Discussionmentioning

confidence: 98%

Pressure sores significantly increase the risk of developing a Fournier's gangrene in patients with spinal cord injury

Backhaus

Citak

et al. 2011

Spinal Cord

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Methods: All patients with a SCI and a Fournier's gangrene treated in our hospital were enrolled in this study. Following parameters were taken form patients medical records: age, type of SCI, cause of Fournier's gangrene, number of surgical debridements, length of hospital and intensive care unit stay, co morbidity factors and mortality rate. In addition, laboratory parameter including the laboratory risk indicator for necrotizing fasciitis (LRINEC) score and microbiological findings were analyzed. Clinical diagnosis was made via histological examination. Results: A total of 16 male patients (15 paraplegic and one tetraplegic) were included in the study. In 81% of all cases, the origin of Fournier's gangrene was a pressure sore. The median LRINEC score on admission was 6.5. In the vast majority of cases, a polybacterial infection was found. No patient died during the hospital stay. The mean number of surgical debridements before soft tissue closure was 1.9 and after a mean time interval of 39.1 days wound closure was performed in all patients. Conclusions: Pressure sores significantly increase the risk of developing Fournier's gangrene in patients with SCI. We reported the results of our patients to increase awareness among physicians and training staff working with patients with a SCI in order to expedite the diagnosis.

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Section: Discussionmentioning

confidence: 98%

Pressure sores significantly increase the risk of developing a Fournier's gangrene in patients with spinal cord injury

Backhaus

Citak

et al. 2011

Spinal Cord

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“…[13][14][15][16][17][18][19] Since the use of scrotal flaps for penile skin defect cover is associated to poor cosmetic results due to the different skin texture and colour and the presence of hairs, skin grafts still represent the solution of choice.…”

Section: Scrotal Reconstructionmentioning

confidence: 99%

Penile reconstruction

Garaffa¹,

Sansalone²,

Ralph³

2012

Asian J Androl

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“…There is marked systemic toxicity out of proportions to local signs. 4 Risk factors include diabetes mellitus, trauma, recent surgery, immunosuppression, IV drug use, HIV infection, systemic lupus erythematosus and morbid obesity. 5 Diagnosis of Fournier's gangrene is mainly clinical, with dramatic out of proportion general condition of the patient with respect to presenting local disease extent.…”

Section: Introductionmentioning

confidence: 99%

“…12 Infection extends rapidly along Colles' and Dartos fascia and via Scarpa's fascia may involve the abdominal wall. 14,16 It has been noted that in Fournier's gangrene, the resultant microvascular thrombosis with subsequent dermal necrosis is due to anaerobes which release enzymes such as collagenase, heparinise along with platelet aggregation and complement fixation induced by aerobes.…”

mentioning

confidence: 99%

“…Since testis has independent blood supply directly from the abdominal aorta via testicular artery, it remains unharmed and orchidectomy is not necessary. 16 Treatment with hyperbaric oxygen for Fournier's is debatable, as its use in any other wound management and may support surgical debridement but not second it. As proven in many studies, early surgical debridement and antibiotic use with hyperbaric oxygen has significant survival advantage.…”

mentioning

confidence: 99%

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A clinical study of management of Fournier’s gangrene in a rural hospital

Shivaraju¹,

Ganapathy

Naveen

et al. 2018

Int Surg J

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Background: Fournier’s gangrene is a potentially life threatening synergistic necrotising fascitis of external genitalia and perineal tissues. It commonly affects young men but can also affect women and children. The use of broad spectrum antibiotics and serial wound debridement is the main stay of treatment. The reconstruction of soft tissue defect following the debridement is a challenging task. The purpose of this study is to evaluate the surgical reconstruction methods of soft tissue defects due to Fournier's gangrene.Methods: This was a prospective study conducted in Adichunchanagiri Institute of Medical Sciences from January 2015 to December 2017. All patients with necrotizing fascitis of external genitalia and perineum, irrespective of age and gender, were included. Parameters such as age, gender, aetiology, predisposing factors, clinical features, defect location, type of bacterial flora, sort of reconstructive procedure used, and duration of hospital stay, post-operative pain, patient satisfaction and mortality, if any, were studied. The choice of reconstructive procedure was based on severity of defect, availability of local tissue and patient preference.Results: Out of 31 cases included in the study, 30 patients underwent reconstructive procedures. The age range was 4 to 74 years (mean 38.5). The commonest presentation was pain, scrotal swelling and fever. The most common aetiology was urogenital diseases. 10 patients were treated by split-thickness skin graft, 5 by secondary suturing, 2 by unilateral superomedial thigh flap, 4 by bilateral superomedial thigh flap, 5 by tensor fascia lata flap, 2 by medial thigh V-Y advancement flap, 2 with perineal artery flap and one case healed by secondary intention.Conclusions: This study suggests that earlier presentation, with early diagnosis and intervention with prompt debridement and appropriate, appropriate antibiotics are the main stays of treatment. The resulting soft tissue defects following wound debridement required surgical reconstruction, except in one case, thus decreasing morbidity, hospital stay and early return of patients to regular life.

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Fournier???s Gangrene: A Review of 43 Reconstructive Cases

Cited by 128 publications

References 32 publications

Pressure sores significantly increase the risk of developing a Fournier's gangrene in patients with spinal cord injury

Pressure sores significantly increase the risk of developing a Fournier's gangrene in patients with spinal cord injury

Penile reconstruction

A clinical study of management of Fournier’s gangrene in a rural hospital

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