Fournier's Gangrene: Diagnostic Approach and Therapeutic Challenge

Abstract

Rapid and accurate diagnosis remains the key to achieving a successful outcome. Abnormal laboratory variables on admission may suggest the diagnosis. Early, repeated, aggressive debridement is essential for a successful outcome.

Fournier’s gangrene: Exists and it is still lethal

“…The mean age of patients in our series was 53.3 years, which is younger to that noted in most published series (mean age 55-65 years) [9].…”

“…The administration of broad spectrum antibiotics (gentamycin -3rd generation cephalosporin) for a long period of time might cause aplasia and the mortality in Fournier's gangrene depends largely on the degree of neutropenia and the duration of aplasia. Mortality rates remain high, ranging between 6 and 67% despite the newer antibiotics and the well known ''aggressive surgical debridement'' [1,9,[12][13][14][15][16]. The aggressive nature of the disease, underlying diseases, and the lack of early diagnosis are some of the reasons for the high mortality rates.…”

New Insights into the Epidemiology and Etiology of Fournier’s Gangrene: A Review of 33 Patients

“…Surgical debridement of necrotic tissue must be repeated until a clean and healthy wound bed is present [15]. As early as 1924, rapid and aggressive debridement had been described and successfully performed by Meleney [4,31]. The use of hyperbaric oxygen remains controversial, and although the beneficial effects of hyperbaric oxygen therapy have been reported in the literature [32], there is increasing doubt as to whether hyperbaric oxygenation has a measurable positive effect on morbidity and mortality [33,34].…”

A review of tobacco and alcohol use literature in the native and migrant Greek community

“…Table II provides a breakdown of the different components of the literature search. Liappas et al 2003;Prendergast et al 2003;Abel 1999;Nencini 1997;Barry 1968;Anonymous 1967Tsakaris et al 2001Daikos et al 2003Kyriazanos et al 2001Xeropotamos et al 2002Chaidemenos et al 2002Tsankov et al 2000Kaklamani et al 1999Blekas et al 2002Kourkoutas et al 2001Schulpis et al 1991 In addition, a quality assurance element was built into the review process. To be included in the final review, papers had to meet the criteria presented in Table III based upon Cormack (1996).…”