Fournier's gangrene current approaches

Abstract

Fournier's gangrene is a rare but highly mortal infectious disease characterised by fulminant necrotising fasciitis involving the genital and perineal regions. The objective of this study is to analyse the demographics, clinical feature and treatment approaches as well as outcomes of Fournier's gangrene. Data were collected retrospectively from medical records and operative notes. Patient data were analysed by demographics, aetiological factors, clinical features, treatment approaches and outcomes. Twelve patients (five female and seven male) were enrolled in this study. The most common aetiology was perianal abscess (41·6%). Wound cultures showed a mixture of microorganisms in six (50%) patients. For faecal diversion, while colostomy was performed in six cases (50%), Flexi-Seal was used in two cases (16·6%). In four patients (33·4%), no faecal diversion was performed. Negative pressure wound therapy (NPWT) system was effective in the last four patients (33·4%). The mean hospitalisation period in patients who used NPWT was 18 days, while it was 20 days in the others. NPWT in Fournier's gangrene is a safe dressing method. It promotes granulation formation. Flexi-Seal faecal management is an alternative method to colostomy and provides protection from its associated complications. The combination of two devices (Flexi-Seal and NPWT) is an effective and comfortable method in the management of Fournier's gangrene in appropriate patients.

Contemporary diagnosis and management of Fournier’s gangrene

“…In a series of 28 consecutive patients with FG, Corman and colleagues found that general surgical service was involved in 52% of the initial operations to perform perianal and sometimes perirectal debridement [Corman et al 1999]. Alternatively, the Flexi-Seal Fecal Management System has been introduced for fecal diversion, which can be utilized as an alternative method to colostomy as it successfully prevents fecal contamination of the wound [Ozkan et al 2014]. In regards to urinary diversion, some authors suggest cystostomy, although most suggest that urinary catheterization provides satisfactory diversion [Yanar et al 2006].…”

Life-Threatening Fournier’s Gangrene Treated by Colostomy and Vacuum Assisted Closure

“…The using of VAC for dressing has several advantages. Ozkan et al stated that VAC increases blood supply and accelerates the formation of granulation tissue by removing bacterial contamination [5]. Since the VAC exchange cycle is longer than that of other dressings, we dressed wounds twice weekly, which means VAC significantly reduced pain associated with dressing.…”

MANAGEMENT OF FLAP DEHISCENCE AFTER LıMBERG PROCEDURE FOR RECURRENT PıLONıDAL DıSEASE BY NEGATıVE PRESSURE WOUND THERAPY (NPWT)

“…NPWT is one of the treatment approaches to increase healthy granulation tissue for complex wounds 7 . It is also known that NPWT is an effective therapy decreasing bacterial contamination in wounds 5 .…”