Complex reconstruction after extreme Fournier’s gangrene; a case report
In this article we present a severe case of Fournier's gangrene (FG) that affected a 64-year-old male patient, with no other known comorbidities. FG is a type of necrotizing fasciitis of the perineal and genital regions, that affects mostly males in the 5th-7th decades, with mortality rates tha...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ion Motofei, Carol Davila University
2020-10-01
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| Series: | Journal of Mind and Medical Sciences |
| Subjects: | |
| Online Access: | https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1256&context=jmms |
| _version_ | 1828476471920820224 |
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| author | Serban Dumitrache Leonida A. Goman Raluca Dutu Raluca Capatina Carmen Giuglea Dan M. Enescu |
| author_facet | Serban Dumitrache Leonida A. Goman Raluca Dutu Raluca Capatina Carmen Giuglea Dan M. Enescu |
| author_sort | Serban Dumitrache |
| collection | DOAJ |
| description | In this article we present a severe case of Fournier's gangrene (FG) that affected a 64-year-old male patient, with no other known comorbidities. FG is a type of necrotizing fasciitis of the perineal and genital regions, that affects mostly males in the 5th-7th decades, with mortality rates that reach 70%. The infection usually advances through the superficial fascial layers of the perineum and abdomen and affects the skin. In our case the infection also affected the spermatic fasciae and advanced in the abdominal and pelvic cavities, abdominal muscles, and surrounding soft tissues. Subsequent debridement left the patient with large soft tissue and muscle defects and an open abdominal cavity that needed reconstruction. We designed two pedicled tensor fascia lata flaps with extra fascia for abdominal support. Healing was marked by a pseudomonas aeruginosa infection that led to skin graft sloughing and marginal wound breakdown, which was treated with antibiotics and local wound care. Eventually the wounds healed, and the patient left the hospital 11 weeks after admittance. The outcome of the case was good considering the initial extent of the infection. The cosmetic shortcomings were not shared by the patient and future scar corrections are planned. |
| first_indexed | 2024-12-11T06:30:12Z |
| format | Article |
| id | doaj.art-15272019b2984e549d6ad654885dbe9d |
| institution | Directory Open Access Journal |
| issn | 2392-7674 2392-7674 |
| language | English |
| last_indexed | 2024-12-11T06:30:12Z |
| publishDate | 2020-10-01 |
| publisher | Ion Motofei, Carol Davila University |
| record_format | Article |
| series | Journal of Mind and Medical Sciences |
| spelling | doaj.art-15272019b2984e549d6ad654885dbe9d2022-12-22T01:17:33ZengIon Motofei, Carol Davila UniversityJournal of Mind and Medical Sciences2392-76742392-76742020-10-017226126410.22543/7674.72.P261264Complex reconstruction after extreme Fournier’s gangrene; a case reportSerban Dumitrache0Leonida A. Goman1Raluca Dutu2Raluca Capatina3Carmen Giuglea4Dan M. Enescu5DEPARTMENT OF PLASTIC SURGERY, ST. JOHN’S CLINICAL EMERGENCY HOSPITAL, BUCHAREST, ROMANIADEPARTMENT OF UROLOGY, “ST. JOHN’S” CLINICAL EMERGENCY HOSPITAL, BUCHAREST, ROMANIADEPARTMENT OF PLASTIC SURGERY, ST. JOHN’S CLINICAL EMERGENCY HOSPITAL, BUCHAREST, ROMANIADEPARTMENT OF PLASTIC SURGERY, ST. JOHN’S CLINICAL EMERGENCY HOSPITAL, BUCHAREST, ROMANIADEPARTMENT OF PLASTIC SURGERY, ST. JOHN’S CLINICAL EMERGENCY HOSPITAL, BUCHAREST, ROMANIACAROL DAVILA UNIVERSITY OF MEDICINE AND PHARMACY, BUCHAREST, ROMANIAIn this article we present a severe case of Fournier's gangrene (FG) that affected a 64-year-old male patient, with no other known comorbidities. FG is a type of necrotizing fasciitis of the perineal and genital regions, that affects mostly males in the 5th-7th decades, with mortality rates that reach 70%. The infection usually advances through the superficial fascial layers of the perineum and abdomen and affects the skin. In our case the infection also affected the spermatic fasciae and advanced in the abdominal and pelvic cavities, abdominal muscles, and surrounding soft tissues. Subsequent debridement left the patient with large soft tissue and muscle defects and an open abdominal cavity that needed reconstruction. We designed two pedicled tensor fascia lata flaps with extra fascia for abdominal support. Healing was marked by a pseudomonas aeruginosa infection that led to skin graft sloughing and marginal wound breakdown, which was treated with antibiotics and local wound care. Eventually the wounds healed, and the patient left the hospital 11 weeks after admittance. The outcome of the case was good considering the initial extent of the infection. The cosmetic shortcomings were not shared by the patient and future scar corrections are planned.https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1256&context=jmmsfournier’s gangrenereconstructionplastic surgery |
| spellingShingle | Serban Dumitrache Leonida A. Goman Raluca Dutu Raluca Capatina Carmen Giuglea Dan M. Enescu Complex reconstruction after extreme Fournier’s gangrene; a case report Journal of Mind and Medical Sciences fournier’s gangrene reconstruction plastic surgery |
| title | Complex reconstruction after extreme Fournier’s gangrene; a case report |
| title_full | Complex reconstruction after extreme Fournier’s gangrene; a case report |
| title_fullStr | Complex reconstruction after extreme Fournier’s gangrene; a case report |
| title_full_unstemmed | Complex reconstruction after extreme Fournier’s gangrene; a case report |
| title_short | Complex reconstruction after extreme Fournier’s gangrene; a case report |
| title_sort | complex reconstruction after extreme fournier s gangrene a case report |
| topic | fournier’s gangrene reconstruction plastic surgery |
| url | https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1256&context=jmms |
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