Síndrome de Fournier secundária a adenocarcinoma de próstata avançado: relato de caso

Batista, Rodrigo Rocha; Filho, Paulo Roberto Ramacciotti; Castro, Carlos Alberto Torres De; Fonseca, Marcus Fábio Magalhães; Albuquerque, Idblan Carvalho de; Formiga, Galdino José Sitonio

doi:10.1590/s0101-98802010000200016

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…Testicle necrosis was rare because of the separate route of blood supply, which is provided by the spermatic vessels 1,6,[23][24][25] . Various types of flaps have been proposed for use in Four nier's syndrome [26][27][28][29] , including the thigh fasciocutaneous flap; it has appropriate thickness, ease of rotation, excellent aesthetic appearance, and rarely undergoes necrosis because of the rich vascularization provided by the internal pudendal and circumflex branches of the femoral artery. Therefore, it is a very safe flap to use, especially in patients with diabetes and vasculopathy.…”

Section: Discussionmentioning

confidence: 99%

Síndrome de Fournier: 10 anos de avaliação

Dornelas¹,

Corrêa²,

Barra³

et al. 2012

Rev. Bras. Cir. Plást.

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Background: Fournier's gangrene is a synergistic necrotizing fasciitis of the perineum and abdominal wall that develops in the scrotum and penis in men and the vulva and groin in women. This disease was initially believed to be idiopathic; however, recent studies have indicated that it is a serious condition caused by gram-positive, gram-negative, or anaerobic bacteria. It is often associated with severe and fatal systemic involvement. Methods: A retrospective study involving a chart review of 23 patients with Fournier's syndrome treated between January 2002 and January 2012 was conducted. Prompt treatment consisted of broad-spectrum antibiotic administration and serial debridement. The reconstruction techniques ranged from edge approximation via simple sutures to the use of flaps and grafts in cases with extensive lesions. Results: The skin and scrotal reconstruction techniques were effective in all cases, yielding satisfactory aesthetic results. Three (13%) patients died, including 2 patients who had previous illnesses and comorbidities. Conclusions: Although Fournier's syndrome is a serious disease, therapeutic measures such as prompt intervention, with early debridement and broad-spectrum antibiotic therapy, in a multidisciplinary approach is very effective for controlling the disease, enabling surgical reconstruction of the affected areas with a low mortality rate.Keywords: Fournier gangrene. Fasciitis, necrotizing. Reconstructive surgical procedures/ methods. RESUMO Introdução:A gangrena de Fournier é uma fasciite necrosante sinérgica do períneo e parede abdominal, que tem origem no escroto e pênis, no homem, e vulva e virilha, na mulher. O processo inicialmente foi descrito como idiopático, mas atualmente sabe-se que se trata de grave afecção causada por bactérias Gram positivas, Gram negativas ou anaeróbios, que pode levar a comprometimento sistêmico importante e, eventualmente, morte. Método: Foi realizado estudo retrospectivo, baseado na análise de prontuários médicos de 23 pacientes portadores de síndrome de Fournier, no período de janeiro de 2002 a janeiro de 2012. O tratamento dos pacientes incluiu intervenção precoce, com antibioticoterapia de largo espectro e desbridamentos consecutivos. O procedimento terapêutico empregado para a reconstrução variou desde a aproximação das bordas com sutura simples até uso de retalhos e enxertos, nas lesões extensas. Resultados: As técnicas de reparação cutânea foram eficientes e a reparação escrotal foi também efetiva em todos os casos, obtendo-se bons resultados estéticos. Houve 3 (13%) óbitos, 2 deles em pacientes com doenças pregressas This study was performed at the

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Section: Discussionmentioning

confidence: 99%

Síndrome de Fournier: 10 anos de avaliação

Dornelas¹,

Corrêa²,

Barra³

et al. 2012

Rev. Bras. Cir. Plást.

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“…[19] Out of risk factors for the Fournier Syndrome, some remarkable ones are diabetes mellitus, malnutrition and obesity, among others. [4,20] This study showed that 17.9% (n = 19) of the patients have diabetes, whereas seven ostomized patients are being treated for Fournier Syndrome. Besides, 39.7% (n = 42) are smokers, and it was observed that 15.1% (n = 16) out of the ostomized have Inflammatory bowel Diseases.…”

Section: Discussionmentioning

confidence: 92%

Life quality for ostomized patients: a perspective in the health and nursing care process

Kimura

Guilhem

Kamada

et al. 2016

JNEP

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Evidence shows that there is association between the quality of life (QoL) of ostomized patients and the results of WHOQOL-bref questionnaire. Mensurable knowledge regarding facets and dimension of the mentioned questionnaire is highly valuable for guidance involving the multidisciplinary crew for nursing care, taken into consideration that specialized care has major influence on the QoL scores. To better assess which of these facets are strongly correlated to tue questionnaire dimensions targeting its identification and the development of internal guidelines take advantage of such information aiming to improve QoL on the one hundred and six patients served by the Ambulatory Care Program for ostomy patients in the Federal District Health Secretariat, Brazil. The questionnaire scores where correlated to the several dimensions in order to pinpoint which of those has major contribution on patients QoL, by generating correlation coefficient (square r) and t-student tests. The facets of Physical Domains, Social Affairs and Environment are correlated with the mean score, resulting in statistically significant associations (p < .0001). The awareness about ostomy patients' reality may result in effective comprehensive health care of the person with ostomy, and the consequent improvement of their QoL, resulting in a process of care in health nursing, which may impact the patient's the ability to socialize and interact, reducing the impact of depression events and its consequences as well as improving the general well being of the patient in terms of self body image and self esteem as required by the Integral health care policy. Thus, the nursing care process becomes an active and continuous act demanding special actions and behaviors targeting the improvement of human potentials, focusing on enhancing the dignity of the ostomized person, for which the nursing care process is fundamental for recovering the QoL scores to better and higher levels.

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“…A síndrome de Fournier está associada a vários fatores causais e comorbidades, sendo descritos como fatores de risco para a Síndrome de Fournier o abscesso anorretal, alcoolismo, diabetes mellitus, cirrose, obesidade, desnutrição, doença vascular periférica, cirurgias orificiais, vasectomia, trauma perineal, neoplasia colorretal avançada, estenose uretral, neoplasias hematológicas, radioterapia, HIV, apendicite, diverticulite aguda, hérnia estrangulada e doença inflamatória intestinal 8 .…”

Section: Discussionunclassified

Terapêutica cirúrgica na síndrome de Fournier: relato de caso

Moreira¹,

Gonçalves

Aucelio³

et al. 2017

Rev. Med. (São Paulo)

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RESUMO:Síndrome de Fournier ou Gangrena de Fournier é uma fasceíte necrotizante que acomete região perineal, perianal e genital, ocasionada por uma infecção polimicrobiana sinergística de bactérias aeróbicas e anaeróbicas, com predomínio em homens em média aos 50 anos. A enfermidade é caracterizada por uma endarteríte obliterante causando trombose vascular subcutânea e necrose de tecidos. Microrganismos distintos aparecem como patógenos nas culturas dos pacientes com essa enfermidade. O quadro clínico pode se manifestar com dor, eritema e edema, cianose e crepitação em bolsa escrotal e períneo associada ou não a febre e calafrios. Diagnóstico e intervenção precoce, com antibioticoterapia de largo espectro e drenagem ampla, permitiu melhores resultados nestes doentes. A mortalidade permanece elevada quando o diagnóstico é tardio e o tratamento operatório retardado. O objetivo do artigo é relatar um caso de Síndrome de Fournier em um paciente de 52 anos e discutir a melhor abordagem cirúrgica e seus impactos no sucesso terapêutico nesta enfermidade.

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Síndrome de Fournier secundária a adenocarcinoma de próstata avançado: relato de caso

Cited by 6 publications

References 5 publications

Síndrome de Fournier: 10 anos de avaliação

Síndrome de Fournier: 10 anos de avaliação

Life quality for ostomized patients: a perspective in the health and nursing care process

Terapêutica cirúrgica na síndrome de Fournier: relato de caso

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