Fournier's gangrene: Seven years of experience in the emergencies service of visceral surgery at Ibn Rochd University Hospital Center

Bensardi, Fatimazahra; Hajri, Amal; Sylvestre, K.; Bouali, Mounir; Bakouri, Abdelilah El; Hattabi, Khalid El; Fadil, Abdelaziz

doi:10.1016/j.amsu.2021.102821

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…Patients with DM had a 2.5 times higher risk of in-hospital mortality than patients without DM. Previous studies have shown the correlation between DM and a poor prognosis in FG patients, aligned with our findings [ 23 – 25 ]. When blood sugars are not properly controlled, diabetes is known to harm the immune system, thus increasing mortality in FG patients [ 25 , 26 ].…”

Section: Discussionsupporting

confidence: 93%

Factors for In-Hospital Mortality in 145 Male Patients with Fournier’s Gangrene: A 10-Year Observational Study from a Single Tertiary Referral Center in Indonesia

et al. 2022

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Background Fournier’s gangrene (FG) is a potentially fatal necrotizing infection. Due to the rapid progression of the disease, the fatality rate remains high despite advances in therapy. This 10-year observational study from a single tertiary referral center in Indonesia aimed to identify the risk factors for in-hospital mortality from 145 male patients diagnosed with FG. Material/Methods This retrospective cohort study was conducted at one of Indonesia’s largest tertiary referral hospitals. The risk factors of in-hospital mortality were analysed using data collected through hospital medical records. All patients diagnosed with FG from January 2012 until December 2021 were included. Outcome measured was sociodemographic factors, comorbidities, laboratory findings, length of stay, culture results, and disease outcome. The microbiological culture was performed on FG lesions isolates. The statistical analysis was conducted using SPSS version 26.0. Results The analysis included 145 male patients with a median age of 52 (IQR, 43–61) years. Of them, 38 (26.20%) patients died. There were more patients with diabetes mellitus (DM) in non-survivor groups compared to survivor groups (76.3% vs 57%, p=0.035). On multivariate analysis, DM and Clostridium perfringens infection were found to be independent factors of in-hospital mortality [adjusted odds ratio (aOR)2.583, 95% confidence interval (CI)=1.061–6.289, aOR 5.982,95% CI=1.241–28.828, respectively]. Conclusions The mortality rate for FG was considerably high. DM and Clostridium perfringens infection were shown to be independent risk factors for mortality among men.

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Section: Discussionsupporting

confidence: 93%

Factors for In-Hospital Mortality in 145 Male Patients with Fournier’s Gangrene: A 10-Year Observational Study from a Single Tertiary Referral Center in Indonesia

et al. 2022

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“…The mean length of hospital stay (LHS) of studied patients in the present study was 54.56 ± 54.57 days. This LHS is longer than that observed in a previous study, where the average length of hospital stay was 13 days [ 14 ].…”

Section: Discussioncontrasting

confidence: 54%

Variables that predict hospital stay and the outcome of Fournier gangrene at King Abdulaziz University Hospital: a retrospective study

Alhubaishy,

Bahassan,

Alsabban

et al. 2024

BMC Urol

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Background The aggressive nature of Fournier gangrene and the associated health issues can result in a more complex clinical course and potentially a longer hospital stay. This study aimed to assess factors that affect the length of hospital stay (LHS) and its relation to the outcome of Fournier gangrene patients. Methods A retrospective study was performed at King Abdulaziz University Hospital (KAUH), Saudi Arabia, on patients diagnosed with Fournier gangrene between 2017 and 2023. Data about length of hospital stay (LHS), age, BMI, clinical and surgical data and outcome was obtained. Results The mean age of the studied patients was 59.23 ± 11.19 years, the mean body mass index (BMI) was 26.69 ± 7.99 kg/m2, and the mean duration of symptoms was 10.27 ± 9.16 days. The most common presenting symptoms were swelling or induration (64%), 88% had comorbidities with diabetes mellitus (DM) (84%), and 76% had uncontrolled DM. of patients, 24% had a poly-microbial infection, with E. coli being the most common (52%). The mean length of hospital stay (LHS) was 54.56 ± 54.57 days, and 24% of patients had an LHS of more than 50 days. Longer LHS (> 50 days) was associated with patients who did not receive a compatible initial antibiotic, whereas shorter LHS was associated with patients who received Impenem or a combination of vancomycin and meropenem as alternative antibiotics following incompatibility. Reconstruction patients had significantly longer LHS and a higher mean temperature. However, none of the studied variables were found to be predictors of long LHS in the multivariate regression analysis. Conclusion Knowledge of the values that predict LHS allows for patient-centered treatment and may be useful in predicting more radical treatments or the need for additional treatment in high-risk patients. Future multicenter prospective studies with larger sample sizes are needed to assess the needed variables and predictors of long LHS.

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“…A narrative review of the literature was performed on PubMed and Scopus using as researching terms “Fournier’s gangrene” and “necrotizing fasciitis”. All the available English language full-text original article, case series, case report of interest, published from January 2013 until December 2021, were reported in the Table 1 [ 10 – 198 ]. Review articles, meeting reports and congress poster and abstracts were all excluded.…”

Section: Introductionmentioning

confidence: 99%

Management of Fournier’s gangrene during the Covid-19 pandemic era: make a virtue out of necessity

Paladini

Cochetti

Tancredi

et al. 2022

Basic Clin. Androl.

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Background Fournier’s gangrene (FG) is a necrotizing fasciitis caused by aerobic and anaerobic bacterial infection that involves genitalia and perineum. Males, in their 60 s, are more affected with 1.6 new cases/100.000/year. Main risk factors are diabetes, malignancy, inflammatory bowel disease. FG is a potentially lethal disease with a rapid and progressive involvement of subcutaneous and fascial plane. A multimodal approach with surgical debridement, antibiotic therapy, intensive support care, and hyperbaric oxygen therapy (HBOT) is often needed. We present the inpatient management of an FG case during the Covid-19 pandemic period. A narrative review of the Literature searching “Fournier’s gangrene”, “necrotizing fasciitis” on PubMed and Scopus was performed. Case presentation A 60 years old man affected by diabetes mellitus, with ileostomy after colectomy for ulcerative colitis, was admitted to our Emergency Department with fever and acute pain, edema, dyschromia of right hemiscrotum, penis, and perineal region. Computed tomography revealed air-gas content and fluid-edematous thickening of these regions. Fournier’s Gangrene Severity Index was 9. A prompt broad-spectrum antibiotic therapy with Piperacillin/Tazobactam, Imipenem and Daptomycin, surgical debridement of genitalia and perineal region with vital tissue exposure, were performed. Bedside daily surgical wound medications with fibrine debridement, normal saline and povidone-iodine solutions irrigation, iodoform and fatty gauze application, were performed until discharge on the 40th postoperative day. Every 3 days office-based medication with silver dressing, after normal saline and povidone-iodine irrigation and fibrinous tissue debridement, was performed until complete re-epithelialization of the scrotum on the 60th postoperative day. Conclusions FG is burdened by a high mortality rate, up to 30%. In the literature, HBOT could improve wound restoration and disease-specific survival. Unfortunately, in our center, we do not have HBOT. Moreover, one of the pandemic period problems was the patient’s displacement and outpatient hospital management. For all these reasons we decided for a conservative inpatient management. Daily cleaning of the surgical wound allowed to obtain its complete restoration avoiding surgical graft and hyperbaric oxygen chamber therapy, without foregoing optimal outcomes.

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Fournier's gangrene: Seven years of experience in the emergencies service of visceral surgery at Ibn Rochd University Hospital Center

Cited by 7 publications

References 22 publications

Factors for In-Hospital Mortality in 145 Male Patients with Fournier’s Gangrene: A 10-Year Observational Study from a Single Tertiary Referral Center in Indonesia

Factors for In-Hospital Mortality in 145 Male Patients with Fournier’s Gangrene: A 10-Year Observational Study from a Single Tertiary Referral Center in Indonesia

Variables that predict hospital stay and the outcome of Fournier gangrene at King Abdulaziz University Hospital: a retrospective study

Management of Fournier’s gangrene during the Covid-19 pandemic era: make a virtue out of necessity

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