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

Czymek, Ralf; Hildebrand, P.; Kleemann, Markus; Roblick, Uwe J.; Hoffmann, Martin; Jungbluth, Thomas; Bürk, C.; Bruch, Hans–Peter; Kujath, P.

doi:10.1007/s15010-008-8169-x

Cited by 96 publications

(91 citation statements)

References 29 publications

(24 reference statements)

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“…Appendix B provides a complete list of co-morbidities counted. There were no differences when looking at the following specific co-morbidities peripheral vascular disease (PVD), hypertension, obesity, and alcoholism, which have been shown previously to be associated with increased incidences of and worse outcomes for NSTI [53,54]. The majority of patients from either cohort had a SOI score consistent with either major or extreme.…”

Section: Cohortmentioning

confidence: 86%

Not Just Full of Hot Air: Hyperbaric Oxygen Therapy Increases Survival in Cases of Necrotizing Soft Tissue Infections

Shaw

Psoinos

Emhoff

et al. 2014

Surgical Infections

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Background: The utility of hyperbaric oxygen therapy (HBOT) in the treatment of necrotizing soft tissue infections (NSTIs) has not been proved. Previous studies have been subject to substantial selection bias because HBOT is not available universally at all medical centers, and there is often considerable delay associated with its initiation. We examined the utility of HBOT for the treatment of NSTI in the modern era by isolating centers that have their own HBOT facilities. Methods: We queried all centers in the University Health Consortium (UHC) database from 2008 to 2010 that have their own HBOT facilities (n = 14). Cases of NSTI were identified by International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes, which included Fournier gangrene (608.83), necrotizing fasciitis (728.86), and gas gangrene (040.0). Status of HBOT was identified by the presence (HBOT) or absence (control) of ICD-9 procedure code 93.95. Our cohort was risk-stratified and matched by UHC's validated severity of illness (SOI) score. Comparisons were then made using univariate tests of association and multivariable logistic regression. Results: There were 1,583 NSTI cases at the 14 HBOT-capable centers. 117 (7%) cases were treated with HBOT. Univariate analysis showed that there was no difference between HBOT and control groups in hospital length of stay, direct cost, complications, and mortality across the three less severe SOI classes (minor, moderate, and major). However, for extreme SOI the HBOT group had fewer complications (45% vs. 66%; p < 0.01) and fewer deaths (4% vs. 23%; p < 0.01). Multivariable analysis showed that patients who did not receive HBOT were less likely to survive their index hospitalization (odds ratio, 10.6; 95% CI 5.2-25.1). Conclusion: At HBOT-capable centers, receiving HBOT was associated with a significant survival benefit. Use of HBOT in conjunction with current practices for the treatment of NSTI can be both a cost-effective and life-saving therapy, in particular for the sickest patients.

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Section: Cohortmentioning

confidence: 86%

Not Just Full of Hot Air: Hyperbaric Oxygen Therapy Increases Survival in Cases of Necrotizing Soft Tissue Infections

Shaw

Psoinos

Emhoff

et al. 2014

Surgical Infections

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“…Due to the rapid progression of necrotizing infection, use of double or triple wide-spectrum antibiotics initially are necessary to bring the infection under control. [48] The most preferred antibiotics according to antibiotic susceptibility results were ciprofloxacin and clindamycin in the present report (Table 5).…”

Section: Ciprofloxacin 40mentioning

confidence: 47%

“…There are reported etiologic causes such as colorectal carcinoma, [44,45] sigmoid carcinoma, [46] perianal/perirectal abscess, [5,29,47,48] ruptured appendicitis, [49,50] sigmoid diverticulitis, [51] Bartholin gland abscess, [2,5,6] renal abscess, [52] urethral stone, [53] urethral stricture, [13,54] etc. The most common etiologic cause was perianal abscess (11.25%) in a total of our cases that followed by chronic perineal irritation (7.5%) and surgically drainage of perianal abscess (3.75%) ( Table 3).…”

Section: Ciprofloxacin 40mentioning

confidence: 99%

Experience of 80 Cases with Fournier's Gangrene and 'Trauma' as a Trigger Factor in the Etiopathogenesis

Eskitaşçıoğlu

Özyazgan

Çoruh

et al. 2014

Ulus Travma Acil Cerrahi Derg

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“…Fournier's gangrene is secondary in 81.8-95.5%, mainly perirectal (16-45%) and genitourinary (20-43%) [1][2][3]5]. Fournier's gangrene is a polymicrobial infection in 82.5% of cases and affects mainly men, with a sex ratio of 10/1 [6,7]. In women, the distribution of causes is more even with a focus on the external and internal genitalia.…”

Section: Discussionmentioning

confidence: 99%

Scrotal reconstruction by inguinal flap after Fournier’s gangrene: A case report and review of literature

Ngaroua¹,

Ngah²,

Bianpambe³

2018

Int J Case Rep Images

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Introduction: Fournier's gangrene is a necrotizing fasciitis of the perineo-scrotal region. It is a medical and surgical emergency justifying a prompt multidisciplinary management. Improvement of the functional and aesthetic outcome is still a big challenge for the medical community. Case Report: This is a case of a Fournier's gangrene in a 25-yearold man, having as risk factors 10 years alcohol consumption and a bad personal hygiene. About 70% of the scrotal skin surface was lost to the debridement. A pedicle inguinal flap was used for scrotal reconstruction, following conventional iterative dressing, with satisfactory esthetic and functional results three months later. Conclusion: Rapid diagnosis followed by a radical debridement is the mainstay of management of Fournier's gangrene. Pedicle inguinal flap is a technique of choice for reconstruction of major scrotal skin defects in resource limited settings.

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

Cited by 96 publications

References 29 publications

Not Just Full of Hot Air: Hyperbaric Oxygen Therapy Increases Survival in Cases of Necrotizing Soft Tissue Infections

Not Just Full of Hot Air: Hyperbaric Oxygen Therapy Increases Survival in Cases of Necrotizing Soft Tissue Infections

Experience of 80 Cases with Fournier's Gangrene and 'Trauma' as a Trigger Factor in the Etiopathogenesis

Scrotal reconstruction by inguinal flap after Fournier’s gangrene: A case report and review of literature

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