Fournier gangrene: experience of a secondary hospital

Michele Potenzoni1, Andrea Prati1, Antonio Savino1, Nicoletta Uliano1, Annamaria Pieri1, Sergio Carmelo Destro Pastizzaro1, Daniel Martens1, Federico Cantoni1, Chiara Grassani1, Roberto Arnaudi1
  • 1 Ospedale di Vaio (Fidenza )

Objective

Fournier gangrene (FG) is an acute and life-threatening bacterial infection disease of soft tissue of the external genital area characterized by a necroticizing fiscitis of perigenital region and tendency of spreading to perineum and perianal region.

Materials and Methods

We reviewed retrospectively the data of 13 patients treated primarily or followed in our center between 2013 and 2016 with FG.
First line treatment consisted in surgically emergency debridement of the necrotic tissue, wide spectrum intravenous antibiotics and later tissue or blood bacteria targeted antibiotics therapy and hyperbaric oxygen therapy.

Results

The median age was 64.8 years old ( range 46-91 years old ). The mean hospital stay of patients was 16 days (range 18-25 days). Diabete mellitus was present in 10 patients, 8 patients were HCV + and 2 patients were indwelling catheter.
The defects were treated primarily in 11 cases with second wound closure and skin flap in 2 cases. The septic state was properly treated in all the cases and the mortality rate of FG was 2/13( 15%) due in both cases to miocardial ischemia.

Conclusion

Early intervention and multidisciplinary approach can reduce mortality in FG patients demanding however important medical supplies.

Reference

A contemporary update on Fournier's gangrene. Hagedorn JC1, Wessells H1.Nat Rev Urol. 2016 Dec 13.
Urologic Emergencies Adam E. Ludvigson, Lisa T. Beaule Surgical Clinics of North America, Volume 96, Issue 3, Pages 407-424

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