The management of Fournier's gangrene: A review of 60 patients
Background: Fournier's gangrene (FG) is a rapidly progressive, destructive, necrotizing fasciitis of perianal, perineal,and genital region. The common clinical symptoms include sudden intense pain in the scrotum, prostration,fever, and pallor. In this study, it was aimed to assess FG in a wider...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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GESDAV
2016-09-01
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| Series: | Archives of Clinical and Experimental Surgery |
| Subjects: | |
| Online Access: | http://www.scopemed.org/fulltextpdf.php?mno=205081 |
| _version_ | 1797923392919175168 |
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| author | Salih Onur Basat Tumay Ipekci Fatih Ceran Mehmet Kisaarslan Mehmet Bozkurt |
| author_facet | Salih Onur Basat Tumay Ipekci Fatih Ceran Mehmet Kisaarslan Mehmet Bozkurt |
| author_sort | Salih Onur Basat |
| collection | DOAJ |
| description | Background: Fournier's gangrene (FG) is a rapidly progressive, destructive, necrotizing fasciitis of perianal, perineal,and genital region. The common clinical symptoms include sudden intense pain in the scrotum, prostration,fever, and pallor. In this study, it was aimed to assess FG in a wider angle.
Methods: 60 patients with the mean age of 55 (ranged between 48-62) that presented with FG in our hospital over a 6 year period between April 2008 and March 2014 were retrospectively reviewed. Age, gender, site of gangrene, risk factors, symptoms, microbiology, treatment modalities, FGSI score, and mortality datas were evaluated.
Results: 60 male patients with the mean age of 55 (ranged between 48-62) were included to the study. 50 patients survived, mortality rate was 16.6%. Septic shock (n: 4), cardiogenic shock (n:4) and pneumonia (n:2) were causes of death. As a risk factor, 45 (75%) patients had DM, 40 (66.6%) patients had HT, and 35 (58.3%) patients had both DM and HT. There were no other co-morbid situation for 10 (16.6%) patients. All the survived 50 patients were suitable for surgical reconstruction. STSG procedure was performed for 46 (76.6%) patients and flap reconstruction was performed for 4 (6.6%) patients. None of the patients had hyperbaric oxygen therapy (HBO). Length of hospitalization was 16 days (5-58) for all patients. A mean FGSI score at admission was of 5.02 +/- 2.45 for survivors compared with 13.8 +/- 4.53 for non-survivors. A mean FGSI score was of 4.56 +/- 2.28 for survivors and 11.50 +/- 2.63 in non-survivors during hospitalization.
Conclusion: Although FG has high mortality rates, appropriate management of the disease can reduce rates. Early diagnosis, surgical debridement, VAC application and antibiotherapy are the essentials for FG. [Arch Clin Exp Surg 2016; 5(3.000): 154-159] |
| first_indexed | 2024-04-10T14:45:38Z |
| format | Article |
| id | doaj.art-50588e8620344560a494a435be0b2d49 |
| institution | Directory Open Access Journal |
| issn | 2146-8133 |
| language | English |
| last_indexed | 2024-04-10T14:45:38Z |
| publishDate | 2016-09-01 |
| publisher | GESDAV |
| record_format | Article |
| series | Archives of Clinical and Experimental Surgery |
| spelling | doaj.art-50588e8620344560a494a435be0b2d492023-02-15T16:07:54ZengGESDAVArchives of Clinical and Experimental Surgery2146-81332016-09-015315415910.5455/aces.20160127010450205081The management of Fournier's gangrene: A review of 60 patientsSalih Onur Basat0Tumay Ipekci1Fatih Ceran2Mehmet Kisaarslan3Mehmet Bozkurt4Bagcilar Training and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Bagcilar/ Istanbul, TURKEY Bagcilar Training and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Bagcilar/ Istanbul, TURKEY Akdeniz University Medical Faculty, Department of Urology Baskent University Alanya Practice and Research Hospital, Department of Urology, Antalya, Turkey Bagcilar Training and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Bagcilar/ Istanbul, TURKEYBackground: Fournier's gangrene (FG) is a rapidly progressive, destructive, necrotizing fasciitis of perianal, perineal,and genital region. The common clinical symptoms include sudden intense pain in the scrotum, prostration,fever, and pallor. In this study, it was aimed to assess FG in a wider angle. Methods: 60 patients with the mean age of 55 (ranged between 48-62) that presented with FG in our hospital over a 6 year period between April 2008 and March 2014 were retrospectively reviewed. Age, gender, site of gangrene, risk factors, symptoms, microbiology, treatment modalities, FGSI score, and mortality datas were evaluated. Results: 60 male patients with the mean age of 55 (ranged between 48-62) were included to the study. 50 patients survived, mortality rate was 16.6%. Septic shock (n: 4), cardiogenic shock (n:4) and pneumonia (n:2) were causes of death. As a risk factor, 45 (75%) patients had DM, 40 (66.6%) patients had HT, and 35 (58.3%) patients had both DM and HT. There were no other co-morbid situation for 10 (16.6%) patients. All the survived 50 patients were suitable for surgical reconstruction. STSG procedure was performed for 46 (76.6%) patients and flap reconstruction was performed for 4 (6.6%) patients. None of the patients had hyperbaric oxygen therapy (HBO). Length of hospitalization was 16 days (5-58) for all patients. A mean FGSI score at admission was of 5.02 +/- 2.45 for survivors compared with 13.8 +/- 4.53 for non-survivors. A mean FGSI score was of 4.56 +/- 2.28 for survivors and 11.50 +/- 2.63 in non-survivors during hospitalization. Conclusion: Although FG has high mortality rates, appropriate management of the disease can reduce rates. Early diagnosis, surgical debridement, VAC application and antibiotherapy are the essentials for FG. [Arch Clin Exp Surg 2016; 5(3.000): 154-159]http://www.scopemed.org/fulltextpdf.php?mno=205081Fournier's GangreneVACtherapyreview |
| spellingShingle | Salih Onur Basat Tumay Ipekci Fatih Ceran Mehmet Kisaarslan Mehmet Bozkurt The management of Fournier's gangrene: A review of 60 patients Archives of Clinical and Experimental Surgery Fournier's Gangrene VAC therapy review |
| title | The management of Fournier's gangrene: A review of 60 patients |
| title_full | The management of Fournier's gangrene: A review of 60 patients |
| title_fullStr | The management of Fournier's gangrene: A review of 60 patients |
| title_full_unstemmed | The management of Fournier's gangrene: A review of 60 patients |
| title_short | The management of Fournier's gangrene: A review of 60 patients |
| title_sort | management of fournier s gangrene a review of 60 patients |
| topic | Fournier's Gangrene VAC therapy review |
| url | http://www.scopemed.org/fulltextpdf.php?mno=205081 |
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