Fournier’s Gangrene: Etiology and Outcome Analysis of 41 Patients

Abstract

Introduction: Fournier’s gangrene (FG) is the necrotizing fasciitis of the perineum and genital area with high mortality. Materials and Methods: A retrospective review included 41 patients diagnosed with FG in our hospitals from 1995 to 2010, divided into survivors and nonsurvivors. We analyzed anamnestic, clinical and laboratory data. Results: The mortality rate was 36.6% (15/41 patients). Elevated heart and respiratory rates, high serum creatinine, low serum bicarbonate, pre-existing kidney disease, and higher median extent of affected body surface were associated with higher mortality. Severe sepsis on admission and hypotension below 90 mm Hg were also predictive for higher mortality. The median FG severity index (FGSI) score was higher in nonsurvivors (11 compared to 6, p < 0.0001). No cases of testicular necrosis were noted. Conclusion: Besides standard clinical and laboratory parameters included in the FGSI calculation, higher extent of affected body surface area and presence of hypotension on admission were also positively associated with mortality.

Are neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as effective as Fournier's gangrene severity index for predicting the number of debridements in Fourner's gangrene?

“…In most series, they are categorized into four groups to determine origin: anorectal, genitourinary, dermatologic, and idiopathic. [2,4,15] In our series, there were 15 anorectal and 3 genitourinary origins. Many predisposal factors have been documented in the literature.…”

“…Tissue necrosis can progress as fast as 2 cm per hour. [13,15,16] Thus, early intervention is very important and life-saving. Our mortality rate (7%) was lower than the literature average of 16-30%.…”

“…This scoring system is widely used in the literature, and there are many studies supporting these results. [13][14][15]19] However, a study by Sallami et al reported the opposite results. [20] Yilmazlar et al [11] modified this scoring system and added two parameters: dissemination degree and age scores.…”

Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier’s Gangrene

“…Although recent technological improvements in antimicrobial agents has increased the spectrum and efficacy of these drugs, early surgical intervention remains the principal therapy for FG because tissue necrosis can rapidly progress (up to 2 cm/h) and sepsis leading to death quickly can develop. 6,7 Many underlying conditions contribute to the formation of FG, such as diabetes mellitus, immunosuppression, local trauma, genitourinary infections, acquired immunodeficiency and malignancy. All of these conditions lead to a decline in the host immunity and contribute to polymicrobial infection.…”

The modern view on the rare purulent-necrotic diseases of the external genitalia in men (review of literature)

“…Развитию ГФ в разной степени способствуют хроническая почечная недостаточность, химиолучевая и кортикостероидная терапия, хроническая обструктивная болезнь легких, курение, хроническая сердечная недостаточность, ишемическая болезнь сердца, артериальная гипертен-зия, стеноокклюзирующий атеросклероз сосудов таза и нижних конечностей, алиментарная недостаточ-ность, цирроз печени и печеночную недостаточность, системная красная волчанка, болезнь Крона, носитель-ство ВИЧ и вируса гепатита С, длительная иммобили-зация (в частности, при острых нарушениях мозгового кровообращения и длительной госпитализации), нару-шение гигиены наружных половых органов [1,2,14,16,44,45,48,49,57,58,64,81,112,117].…”