Hyperbaric oxygen therapy decreases mortality due to Fournier’s gangrene: a retrospective comparative study

Féres, Omar; Feitosa, Marley Ribeiro; Rocha, José Joaquim Ribeiro da; Miranda, Juliana Mamede; Santos, Luciana Egydio Dos; Féres, Artur Cury; Camargo, Hugo Parra de; Parra, Rogério Serafim

doi:10.4103/2045-9912.310055

Cited by 16 publications

(12 citation statements)

References 47 publications

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“…In our study, the mortality rate was 25%. Other case series show mortality rates that vary from 3.7% up to 76% (9,11). Comorbidities play an important role in determining the survival of FG patients.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, both diseases are potentially fatal and related to microvascular dysfunction. Necrotizing softtissue infection is recognized as a severe softtissue infection that spreads rapidly, and it is associated with a high mortality (11).…”

Section: Discussionmentioning

confidence: 99%

“…FG is a polymicrobial soft-tissue infection of the genital and perineal region that results in necrosis of tissues, and it progresses rapidly (11). Epidemiologically, patients with diabetes mellitus, obesity, alcohol dependence, and who use illegal substances are at the highest risk.…”

Section: Discussionmentioning

confidence: 99%

“…There are systemic diseases associated with the development of FG, including obesity, diabetes mellitus, systemic arterial hypertension, alcoholism, and tobacco use. In addition, there are other risk factors for FG, such as rectal cancer (10) and in situations where the individual is immunocompromised, such as infection by the human immunodeficiency virus (HIV), radiation therapy and chemotherapy, steroid use, and postoperative complications (11). However, there are no reports on the association between FG and COVID-19.…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 and Fournier’s Gangrene: Is there a Correlation Between Both Diseases?

Parra¹,

Feitosa²,

Freitas³

et al. 2023

JHS

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Background: Reports on the development of Fournier's Gangrene (FG) in patients with coronavirus disease 2019 (COVID-19) are rare. Aim: This study reports a series of cases of patients with both diseases and to summarize the literature on the subject. Methods: We retrospectively examined electronic medical records dated between March 2020 and December 2021 of all adult patients with COVID-19 admitted to the Clinics Hospital of Ribeirão Preto (HCFMRP-USP) to identify those who had a diagnosis of FG. The diagnosis of COVID-19 was made by RT-PCR. We assessed the following patient characteristics: age; sex; tobacco use; laboratory data; and comorbidities such as human immunodeficiency virus (HIV), obesity, diabetes mellitus, systemic arterial hypertension, and alcoholism. Results: Four patients met the inclusion criteria. All the patients were female and had at least two comorbidities, including obesity (n=4, 100%), systemic arterial hypertension (n=3, 75%), diabetes mellitus (n=2, 50%), cardiovascular disease (n=1, 25%), chronic kidney disease (n=1, 25%), and hematologic disorders (n=1, 25%). They were all admitted to the intensive care unit and underwent surgical debridement under anesthesia. All the patients received hyperbaric oxygen therapy. The mean age was 62.75 years (range 60-66 years), and the mean length of stay was 30 days (range 22-37 days). One patient died (n=1, 25%). Conclusion: This is the first report in the literature on a series of cases of FG in patients with COVID-19. FG associated with COVID-19 is a serious, potentially lethal condition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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COVID-19 and Fournier’s Gangrene: Is there a Correlation Between Both Diseases?

Parra¹,

Feitosa²,

Freitas³

et al. 2023

JHS

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“…It has a direct antibacterial impact on anaerobes and decreases the activity of endotoxins by creating a media with high oxygen levels. [ 13 ] If the perineal or anorectal regions are affected, colostomy might be preferred, because it prevents fecal contamination and causes faster-wound healing. [ 14 ]…”

mentioning

confidence: 99%

What Has Changed in the History of Fournier's Gangrene Treatment: The Single Center Experience

Kutsal¹

2023

Sisli Etfal

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Objectives: Fournier’s gangrene (FG) is a rapidly progressive infection that requires emergent intervention. Wound closure is an important treatment step after surgery, and vacuum-assisted closure (VAC) can be preferred as an alternative method for wound closure. FG severity index (FGSI) scales that can be developed to evaluate the prognosis in FG. This study aims to compare VAC therapy, which was used and developed in the historical development of FG therapy, with conventional wound dressing (CWD). Methods: Data on who 85 patients treated at our hospital with a diagnosis of FG from January 2010 to July 2021. In the VAC group, the vacuum device was applied in a sealed manner. In the CWD group, mesh dressing was prepared. The VAC device was adjusted to subatmospheric pressure. Broad-spectrum antibiotics were administered to all patients during their follow-up. During the follow-up, as necrotic tissues were detected, redebridements were performed by providing appropriate analgesia and anesthesia. Demographic data of the patients were collected on the records. The clinical and laboratory data were obtained from the records at the 1st h, 72 h, and 1st week FSGI values were calculated. In statistical analysis, continuous variables were expressed as mean±standard deviation, ordinal variables were expressed as median [IQR], and categorical variables were expressed as n (%). In intergroup analyses, student’s t-test was used if the data were normally distributed. If it did not show normal distribution, the Mann–Whitney U-test was applied. Results: Fifty-five patients who were diagnosed with FG were included in our study. CWD was applied to 18 patients, and VAC was applied to 37 patients. The mean 1st h FGSI of the patients who used VAC was 7.05 (3.75–8), and the patients who had CWD were 5.5 (5–9) (p=0.067). Mean 72nd-h FGSI was found to be 5.35 (3.5–7) in the VAC group and 5.33 (4.75–6.25) in the CWD group (p=0.714). The mean 1st-week FGSI VAC group was 2.97 (1–5), and in the CWD group, it was 5 (4–6) (p=0.0001). Conclusion: VAC significantly reduces the length of hospital stay. In our analysis, both groups observed a significant difference between the 1st-week FGSIs. This is the first study to evaluate FGSI, which is an essential predictor of the effect of VAC therapy used in treating FG. In the history of FG treatment, CWD has been replaced by VAC.

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