scholarly journals AB185. SOH21AS226. The management of Fournier’s Gangrene in an Irish university hospital: a case series

2021 ◽  
Vol 5 ◽  
pp. AB185-AB185
Author(s):  
Lynda Condell ◽  
Morgan Peter McMonagle ◽  
Megan Power-Foley
Keyword(s):  
Case Series ◽  
Fournier’S Gangrene ◽  
University Hospital ◽  
Fournier's Gangrene

Dangers of delayed diagnosis of perianal abscess and undrained perianal sepsis in Fournier’s gangrene: a case series

2020 ◽  
Vol 13 (10) ◽  
pp. e236503
Author(s):  
Edgardo Solis ◽  
Yi Liang ◽  
Grahame Ctercteko ◽  
James Wei Tatt Toh
Keyword(s):  
Delayed Diagnosis ◽  
Case Series ◽  
Perianal Abscess ◽  
Scoring Systems ◽  
Fournier’S Gangrene ◽  
Necrotising Fasciitis ◽  
Risk Indicator ◽  
Fournier's Gangrene ◽  
Perianal Sepsis

Fournier’s gangrene (FG) is a rapidly progressing infective necrotising fasciitis of the perianal, perineal and genital region. It is characterised by its aggressive nature and high mortality rates of between 15% and 50%. While it has been commonly found to primarily develop from urological sources, there have been increasing reports of the role of colorectal sources as the underlying aetiology of FG. Presented is a case series of four FG presentations at a single institution during a 12-month period as a result of underlying untreated perianal disease highlighting its dangers in progressing to a deadly infection, advocating for early and aggressive surgical debridement, and the role of adjunct scoring systems, such as Laboratory Risk Indicator for Necrotising Fasciitis, in guiding clinical diagnosis.

Fournier's gangrene: not as lethal as previously thought? A case series

2018 ◽  
Vol 89 (4) ◽  
pp. 350-352 ◽  
Author(s):  
Bridget Heijkoop ◽  
Natalie Parker ◽  
Daniel Spernat
Keyword(s):  
Case Series ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene

scholarly journals Which Role for Hyperbaric Oxygen Therapy in the treatment of Fournier’s gangrene? A Retrospective Study.

2020 ◽  
Author(s):  
Roberta Tutino ◽  
Francesco Colli ◽  
Giovanna Rizzo ◽  
Leo Licari ◽  
Gaetano Gallo ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Stay ◽  
Fournier’S Gangrene ◽  
University Hospital ◽  
Surgical Operation ◽  
Fournier's Gangrene ◽  
Great Loss ◽  
Hospital Stays ◽  
Hyperbaric Therapy ◽  
The University

Abstract Background: In Fournier’s gangrene the surgical debridement plus broad-spectrum antimicrobial therapy is the mainstay treatment but can cause a great loss of tissue. Moreover, the local poor blood supply, the infection and the damage to the vessels can delay the healing. Consequently, the disease needs long hospital stays and, despite all, has high mortality rate. The aim of our study is to investigate the improvement offered by hyperbaric therapy in Fournier’s gangrene.Methods: We retrospectively evaluated data on 23 consecutive patients admitted for Fournier’s gangrene at the University hospital “P.Giaccone” of Palermo from 2011 to 2018. The relation between hyperbaric therapy, hospital stay and mortality was evaluated. Factors related to mortality were also examined.Results: The use of hyperbaric therapy was offered to 13(56.5%) patients. Hospital stay was longer in patients treated with HBOT[mean11(C.I.0.50-21,89)vs25(C.I.18.02-31.97);p=0.02]. Mortality occurred in three patients(13.1%), two of whom treated with HBOT. Mortality was not statistically related to sex(p=0.20), BMI(p=0.53), renal failure (p=1.00), diabetes(p=0.49), age>65 years old(p=0.55), simplified FGSI>2(p=0.05), higher ASA scores(>=4)(p=0.47), symptoms at admission lasting since more than 72 hours (p=0.28), HBOT(p=1.00), need of colostomy(p=0.06), several operations(p=1.00), several operations plus HBOT(P=1.00). Conversely, the delay between admission and surgical operation was statistically related to mortality, 1.7 days(C.I.0.9-3.5) in survivals vs 6.8 days(C.I.3.5-13.4) in death patients(p=0.001).Conclusions: Our study proves that a delay in the treatment of patients with Fournier’s gangrene has a correlation with the mortality rate, while the use of HBOT seems to not improve the survival rate, increasing the hospital stay instead.

scholarly journals A Study of Fournier’s Gangrene and Its Management: Case Series of 35 Cases

2020 ◽  
Vol 6 (10) ◽  
pp. 332-336
Author(s):  
Dr. Vijaykumar S Kappikeri ◽  
Dr. Yeshwanth V ◽  
Dr. Nitin Kalaskar
Keyword(s):  
Case Series ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene

scholarly journals Predisposition Factors Analysis for Fournier’s Gangrene Defects Closure Complication

2021 ◽  
Vol 5 (1) ◽  
pp. 13
Author(s):  
Bayu Fasi Bermani ◽  
Sitti Rizaliyana ◽  
Ira Handriani
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Medical Records ◽  
Early Recognition ◽  
Severe Disease ◽  
Case Series ◽  
Fournier’S Gangrene ◽  
Defect Closure ◽  
Fournier's Gangrene ◽  
Fournier Gangrene

Background: Fournier’s gangrene is a rare and rapidly progressive, necrotizing fasciitis affecting the external genitalia and perineum. Based on the case series that have been reported, the incidence rate of this case is 88% with mortality rate of 20%-40%. The study aims to share our policy in managing Fournier’s gangrene and identifying risk factors that can affect the outcome of defect closure.Method: The medical records of 10 patients with Fournier’s gangrene who presented at the Dr. Soetomo Hospital Surabaya from January 2017 to December 2018 were reviewed retrospectively. We analyzed characteristics of the patients, risk factors, methods of defect closure, and case outcome. There are 10 Fournier’s gangrene patients at Dr. Soetomo Academic General Hospital from January 2017 to December 2018. We analyzed the patient’s medical records retrospectively on the patient’s characteristics, risk factors, method of closing Fournier’s gangrene defects, and the final outcome of the case.Results: There were ten men enrolled in the study, and the mean age was 49.3 ± 11.51 years. All patients received broad-spectrum antibiotic therapy, and extensive surgical excision. This study found that diabetes mellitus and uncontrolled patient blood sugar levels, statistically there is no effect on failure of defect closure in Fournier gangrene patients, but clinically, the relative risk value shows that blood glucose levels have a risk factor of 6 times. increasing the incidence of failure to close the Fournier gangrene defect.Conclusions: Fournier’s gangrene is still considered a severe disease with fairly high mortality rate. Early recognition of predisposition factors associated with invasive and aggressive treatment options is very important in efforts to to reduce morbidity.

scholarly journals A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nan Zhang ◽  
Xin Yu ◽  
Kai Zhang ◽  
Tongjun Liu
Keyword(s):  
Necrotizing Fasciitis ◽  
Case Series ◽  
Fournier’S Gangrene ◽  
Wound Management ◽  
Risk Indicator ◽  
Fournier's Gangrene ◽  
Retrospective Case ◽  
Female Ratio ◽  
Male Predominance ◽  
Lrinec Score

Abstract Background To describe the clinical characteristics and management for Fournier’s gangrene. Experience summary and literature references are provided for future treatment improvement. Methods We retrospectively reviewed the cases diagnosed with Fournier’s gangrene in our department from June 2016 to June 2019. Clinical data, including manifestation, diagnosis, treatment and outcomes for Fournier’s gangrene were presented. Results There were 12 patients enrolled in this paper, with the average age of 60 years old. It showed a male predominance with male-to-female ratio of 6:1. The average of laboratory risk indicator for necrotizing fasciitis (LRINEC) score was 10.1. Diabetes mellitus was the main predisposing disease. 11 patients received emergency debridement and 1 patient died of sepsis on the 2nd day after admission. The mortality rate was 8.3%. 6 cases developed complications, including sepsis, pneumonia, renal and heart failure. Negative pressure wound therapy (NPWT) was applied in 10 cases, while the rest 1 received normal daily dressing changes because of fecal contamination. Flaps were utilized in 2 patients to cover the defect, including one with advancement flap and one with pudendal-thigh flap, while others received secondary suture, secondary healing, skin graft or combined management. No relapse was observed during the follow-up visits. Conclusions Fournier’s gangrene is a life-threatening infection that requires early diagnosis and surgery intervention. The predisposing disease, clinical manifestation and LRINEC score should be taken into comprehensive consideration, which is helpful for timely diagnosis. Moreover, further successful treatment depends on the aggressive debridement, broad-spectrum antibiotics therapy, wound management and closure choice.

UP-01.127 Management of Fournier's Gangrene: A Case-Series of 20 Patients

Urology ◽  
2011 ◽  
Vol 78 (3) ◽  
pp. S227
Author(s):  
M. Wischnack ◽  
A. Schröder ◽  
J. Thüroff ◽  
R. Stein
Keyword(s):  
Case Series ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene

scholarly journals Pudendal flap—a good option for creating neo-scrotum after Fournier’s gangrene: a case series

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
Bhawani Khanal ◽  
Sunit Agrawal ◽  
Roshan Gurung ◽  
Suresh Sah ◽  
Rakesh Kumar Gupta
Keyword(s):  
Single Case ◽  
Case Series ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Average Body Mass Index ◽  
Skin Loss ◽  
Average Body Mass ◽  
Average Defect ◽  
Protective Sensation ◽  
Average Body

Abstract Scrotal skin loss following Fournier’s gangrene is very distressing to the patients. The management is complex and challenging shown by the multiplicity of flaps and techniques described in the literature. We included a total of 14 patients with the diagnosis of Fournier’s gangrene over a period of 1 year in our department. We used a modified pudendal thigh flap to reconstruct neo-scrotum in patients with scrotal defects resulting from excision and debridement of Fournier’s gangrene. The average age group of the patients in our study was 41.8 years. The average body mass index in our study was 22.36 kg/m2. The average defect size in our study was 7.05 × 13.07 cm2. There was a single case of flap necrosis. Modified pudendal thigh flap produces a neo-scrotum that looks natural in appearance, provides good quality skin cover and cushion to the testes as well as protective sensation.

scholarly journals New Methods of Reconstruction for Old Challenges: The Use of the Integra Graft in Necrotizing Soft Tissue Infections of the Male Genitalia

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Katharina Mitchell ◽  
Chad Crigger ◽  
Chad Morley ◽  
John Barnard ◽  
Vidas Dumasius
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
External Genitalia ◽  
Skin Grafting ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Bovine Collagen ◽  
Necrotizing Soft Tissue Infections ◽  
Perineal Region ◽  
Methods Of Reconstruction

In this paper, we describe two cases of Fournier’s gangrene (FG) in which Integra grafting was used for reconstruction. FG is a progressive necrotizing infection occurring in the perineal region and on the external genitalia. Reconstructive options using local tissue are limited due to the destruction this infection imposes on the soft tissue. Integra graft is a bilaminate artificial dermis made of shark chondroitin 6-sulfate and bovine collagen. It is applied to the wound bed after debridement and establishment of a healthy, well-vascularized wound base. The patients in this case series had large defects which could not be closed primarily with tissue beds and would not have been appropriate for skin grafting. Therefore, an Integra graft was placed. In both patients, the wound beds were appropriate for skin grafting after three weeks. Without the Integra graft, both of our patients would have needed to wait a considerable amount of time prior to reconstruction. Our case series further illustrates and supports the use of Integra grafts in such a scenario following Fournier’s gangrene which has only previously been published on three occasions, all of which demonstrated successful outcomes.

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