Prognostic Factors in Fournier’s Gangrene

Abstract

BACKGROUND: Fourniers gangrene is a fatal necrotising fasciitis of the perineal region which requires aggressive medical or prompt surgical treatment. AIM: Aim of the study is to study its risk and predisposing factors along with the clinical course and management techniques. Predictive values of Fournier Gangrene Severity Index Score was calculated. MATERIALS AND METHODS: In a prospective case review between july2012 to July 2014, predisposing factors, clinical course and FGSI score for all cases of Fourniers gangrene was evaluated. RESULTS: Commonest affected age group was 40-60 years with an average of 50 years and. The disease more commonly affects in lower socioeconomic group. Diabetes and alcoholism were significantly associated with the disease and association of co-morbidities gravely influences the prognosis. Average time before referral for treatment was 6.4days in the survival group and 31.66 days in the non-survival group. FGSI ˂7 had a better outcome, however FGSI˃9 had high mortality rate (20%). CONCLUSION: Older age group patients ˃50 years had significant morbidity and mortality. FGSI is an effective score for mortality assessment with a high predictive value. Early detection of patients followed by adequate surgical debridement and proper antibiotic cover, yields good results.