Fournier’s gangrene: clinic, diagnostics, treatment

Бордаков, П. В.; Бордаков, В. Н.; Гаин, Ю. М.; Шахрай, С. В.; Gain, M.

doi:10.17650/2408-9613-2017-4-1-14-23

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Исходом раневого процесса является формирование рубцовой ткани с минимальными проявлениями фиброза, появлением нормотрофического рубца [17,18]. Считается, что патологический рубец является фибропролиферативным состоянием кожи и возникает при длительном воспалительном процессе на любом из этапов заживления раневых дефектов, что в свою очередь приводит к увеличению количества фибробластов, накоплению экстрацеллюлярного матрикса [19].…”

Section: результатыunclassified

Analysis of Opportunities and Prospects of Lipofilling Method in Patients with Atrophic Skin Scarring: A Literature Review

Галицкая,

Дундаров,

Евсеенко

et al. 2023

Хирургия. Восточная Европа

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В статье освещены современные научные данные, посвященные анализу методики трансплантации аутологичной жировой ткани. Освещена морфологическая и биохимическая характеристика патологически измененной ткани до выполнения оперативного вмешательства с целью контурной коррекции рубцовой деформации. Собраны современные научные классификации рубцовых изменений кожных покровов. Проведен анализ показаний к применению метода липофилинга. Указаны перспективы использования комбинации лекарственных средств, характеризующихся антиоксидантной активностью. Обозначена возможность биохимической и морфологической оценки локального состояния антиоксидантного статуса реципиентной зоны после классической контурной коррекции в комбинации с использованием антиоксидантов с целью улучшения результатов реабилитации пациентов с рубцовыми деформациями атрофического характера различной этиологии. The article covers modern scientific data devoted to the analysis of the technique of autologous adipose tissue transplantation. Morphological and biochemical characteristics of the pathologically changed tissue before surgical intervention for scar deformity contouring are highlighted. Modern scientific classifications of cutaneous scar changes have been collected. The analysis of indications for lipofilling method application was carried out. Prospects of using combinations of drugs characterized by antioxidant activity are indicated. The possibility of biochemical and morphological evaluation of local state of antioxidant status of the recipient area after classical contour correction in combination with antioxidants to improve rehabilitation results of patients with atrophic scar deformities of various etiologies is outlined.

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Section: результатыunclassified

Analysis of Opportunities and Prospects of Lipofilling Method in Patients with Atrophic Skin Scarring: A Literature Review

Галицкая,

Дундаров,

Евсеенко

et al. 2023

Хирургия. Восточная Европа

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“…Гангрена Фурньє у дітей є казуїстичним захворюванням, зустрічається вкрай рідко та супроводжується високим відсотком летальності, пошук засобів закриття ранових поверхонь досі триває. Пропонуються місцеві, еспандерні, вільні та комбіновані пластики [2].…”

Section: актуальністьunclassified

Use of the cutaneous-subcutaneous-fascial rotational flap on nutrition branch for covering surface defects in children

Bodnar¹,

Sokolnyk²,

Vatamanesku³

et al. 2020

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Introduction. Diseases that are accompanied by significant cutaneous-subcutaneous-fascial defects during surgery in children include: pilonidal cyst (PC), spinal hernia (SH), Fournier’s gangrene and wounds. Various methods of surgical treatment of PC consist of the stages: removal of the cyst and covering the wound surface with suturing or leaving the wound surface open. The existing methods of covering a defect in SH in children cannot satisfy surgeons, because they are accompanied by significant tissue tension, which causes complications. Fournier’s gangrene in children is a rare disease with a large area of soft tissue damage. Initial surgical debridement of wounds in childhood requires an individual approach with the choice of the correct method to close the defect. Purpose. To study the possibilities of using the rotation of vascularized cutaneous-subcutaneous-fascial flap (CSFF) for the surgical treatment of superficial defects in children. Materials and methods. The surgical treatment of superficial defects in 73 children in a City Children’s Hospital (Chernivtsi) with PC (29 children), SH (20 children), wounds of the face, limbs and trunk (23 children), Fournier gangrene (1 child) was analyzed. We compared the performing of traditional methods of treatment and rotational methods of using CSFF. Recovery time and postoperative complications were analyzed. Results. By using traditional methods of treating PC, complications were observed in 50%, when using the proposed plastic surgery with rotational CSFF in 6.67%; in case of SH – in 44.44% and 18.18%, with wounds – in 27.27% and 8.33%, respectively. Plastic reconstruction in Fournier’s gangrene recovered on the 40th day of the postoperative period. Conclusion. The use of cutaneous-subcutaneous-fascial rotational flap with perforating vessels surgery allows to reduce the amount of complications after operations for PC, SH, initial surgical debridement of wounds, Fournier’s gangrene. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Key words: cutaneous-subcutaneous-fascial flaps, superficial defects, children.

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Efficacy and safety of negative wound pressure in the treatment of surgical complications after radical cystectomy: a retrospective cohort study

Berkut,

Belyaev,

Krotov

et al. 2024

Almanac of Clinical Medicine

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Background: Negative pressure wound treatment (NPWT) is a relatively new, but promising method for management of surgical site infection (SSI). The literature data on the use of NPWT for complications in oncology surgery, and after radical cystectomy (RC) in particular, is scarce. Aim: To evaluate the short-term results of NPWT dressings in the management of SSI after RC. Materials and methods: We retrospectively analyzed data from 446 patients who had RC with various uroderivation types in the Department of Oncourology of the N. N. Petrov National Medical Research Center of Oncology from January 2012 to December 2021. A total of 62 cases of SSI emerging up to day 30 after RC were identified with complete data. Thirty six (36) cases of SSI were managed according to standard procedures, and 26 patients with SSI were treated with NPWT (VivanoTec® S 042) at constant negative pressure mode. The physical condition of the patients before RC was assessed according to the American Society of Anesthesiology (ASA) classification, and the severity of the patient's condition at SSI diagnosis within APACHE II scale. The following parameters were also analyzed: body mass index, median number of days in the hospital, number of program wound sanitations (surgical debridement) or frequency of changing NPWT dressings, changes over time in C-reactive protein and leukocyte index of intoxication, and events of clinical interest (intestinal fistulas and lateralization of the median wound margins, hernias). Results: Most cases of post-RC SSIs were identified in men (57/62, 91.93%). The standard management and NPWT study groups were well balanced for age, body mass index, and ASA physical status. The median time from the first surgical debridement of the wound to its closure was significantly shorter in the standard surgical management group: 4 days (0; 8.75) versus 8.5 days (3.25; 12.0) in the NPWT group (p = 0.026). However, this did not negatively affect the length of hospitalization (28.08 ± 12.80 and 30.03 ± 16.27 days, respectively, p = 0.599). The 30-day mortality rates were not significantly different between the groups (p = 0.137). In our series with NPWT dressings, there were no cases of intestinal fistulas in the early and late postoperative periods. Conclusion: Negative pressure wound treatment is a safe and effective method of SSI management. It is not inferior to the generally accepted treatment standard with surgical wound debridement, staged sanitations or dressings. NPWT dressings allow for early primary muscular-fascial closure of the abdominal cavity and does not increase the duration of hospital stay, postoperative death rates and the risk of intestinal fistulas.

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Fournier’s gangrene: clinic, diagnostics, treatment

Cited by 4 publications

References 7 publications

Analysis of Opportunities and Prospects of Lipofilling Method in Patients with Atrophic Skin Scarring: A Literature Review

Analysis of Opportunities and Prospects of Lipofilling Method in Patients with Atrophic Skin Scarring: A Literature Review

Use of the cutaneous-subcutaneous-fascial rotational flap on nutrition branch for covering surface defects in children

Efficacy and safety of negative wound pressure in the treatment of surgical complications after radical cystectomy: a retrospective cohort study

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