scholarly journals Analysis of prognostic factors affecting mortality in Fournier’s gangrene: A study of 72 cases

2015 ◽  
Vol 9 (11-12) ◽  
pp. 800 ◽  
Author(s):  
Mohamed Tarchouli ◽  
Ahmed Bounaim ◽  
Mohamed Essarghini ◽  
Moulay Brahim Ratbi ◽  
Mohamed Said Belhamidi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Mortality Rate ◽  
Patient Survival ◽  
Length Of Hospital Stay ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Predisposing Factor ◽  
Duration Of Symptoms ◽  
Factors Affecting

Introduction: Fournier’s gangrene is a rapidly progressing necrotizing fasciitis of the perineum and genital area associated with a high mortality rate. We presented our experience in managing this entity and identified prognostic factors affecting mortality.Methods: We carried out a retrospective study of 72 patients treated for Fournier’s gangrene at our institution between January 2005 and December 2014. Patients were divided into survivors and nonsurvivors and potential prognostic factors were analyzed.Results: Of the 72 patients, 64 were males (89%) and 8 females (11%), with a mean age of 51 years. The most common predisposing factor was diabetes mellitus (38%). The mortality rate was 17% (12 patients died). Statistically significant differences were not found in age, gender, and predisposing factors, except in heart disease (p = 0.038). Individual laboratory parameters significantly correlating with mortality included hemoglobin (p = 0.023), hematocrit (p = 0.019), serum urea (p = 0.009), creatinine (p = 0.042), and potassium (p = 0.026). Severe sepsis on admission and the extent of affected surface area also predicted higher mortality. Others factors, such as duration of symptoms before admission, number of surgical debridement, diverting colostomy and length of hospital stay, did not show significant differences. The median Fournier’s Gangrene Severity Index (FGSI) was significantly higher in non-survivors (p = 0.002).Conclusion: Fournier’s gangrene is a severe surgical emergency requiring early diagnosis and aggressive therapy. Identification of prognostic factors is essential to establish an optimal treatment and to improve outcome. The FGSI is a simple and valid method for predicting disease severity and patient survival.

FOURNIER'S GANGRENE: ANALYSIS OF PROGNOSTIC FACTORS AND VALIDATION OF THE FOURNIER'S GANGRENE SEVERITY INDEX IN A LARGE SERIES

2009 ◽  
Vol 181 (4S) ◽  
pp. 67-67
Author(s):  
Saturnino Luján ◽  
Alberto Budía ◽  
Carlos Di Capua ◽  
Miguel Ramírez ◽  
Enrique Broseta ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Large Series ◽  
Fournier's Gangrene

445 FOURNIER'S GANGRENE: ANALYSIS OF PROGNOSTIC FACTORS AND VALIDATION OF THE FOURNIER'S GANGRENE SEVERITY INDEX IN A LARGE SERIES

2009 ◽  
Vol 8 (4) ◽  
pp. 232
Author(s):  
S. Luján Marco ◽  
C. Di Capua ◽  
A. Budía ◽  
E. Broseta ◽  
M. Ramírez ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Large Series ◽  
Fournier's Gangrene

The Prognostic Factors and Severity Index in Fournier's Gangrene

2010 ◽  
Vol 26 (1) ◽  
pp. 29 ◽  
Author(s):  
Kwang-Min Kim ◽  
Seung Hoon Seong ◽  
Dal Yeon Won ◽  
Hoon Ryu ◽  
Ik Yong Kim
Keyword(s):  
Prognostic Factors ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene

scholarly journals Fournier's Gangrene: A Summary of 10 Years of Clinical Experience

2015 ◽  
Vol 100 (5) ◽  
pp. 934-941 ◽  
Author(s):  
Abdullah Oguz ◽  
Metehan Gümüş ◽  
Ahmet Turkoglu ◽  
Zübeyir Bozdağ ◽  
Burak Veli Ülger ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Length Of Hospital Stay ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fecal Diversion ◽  
Patient Comfort ◽  
Fournier's Gangrene ◽  
Duration Of Treatment ◽  
Progressive Necrosis ◽  
Serious Disease

We aimed to present our clinical experience with FG treatment. Fournier's gangrene (FG) is a rare but serious disease characterized by progressive necrosis in the genitourinary and perineal region. The retrospective study included 43 patients. Patients were divided into 2 groups as survivors and nonsurvivors. Included in the analysis were data pertaining to demographics, predisposing factors, comorbidities, results of bacteriologic analyses, number of debridements, duration of treatment, FG Severity Index (FGSI) score, fecal diversion methods (trephine ostomy or Flexi-Seal Fecal Management System-FMS), and dressing methods (wet or negative aspiration system). In the nonsurvivor group, urea, WBC, and age were significantly higher, whereas albumin, hematocrit, platelet count, and length of hospital stay (LOHS) were significantly lower compared to the survivor group. Mean FGSI was lower in survivors in comparison with nonsurvivors (5.00 ± 1.86 and 10.00 ± 1.27, respectively; P < 0.001). We conclude that FGSI is an important predictor in the prognosis of FG. Vacuum-assisted closure (VAC) should be performed in compliant patients in order to enhance patient comfort by reducing pain and the number of dressings. Fecal diversion should be performed as needed, preferably by using FMS. The trephine ostomy should be the method of choice in cases where an ostomy is necessary.

scholarly journals The effectiveness of Dakin’s solution in wound care after debridement in Fournier’s gangrene

2020 ◽  
Vol 7 (7) ◽  
pp. 2156
Author(s):  
Onur Karsli ◽  
Fatih Gokalp
Keyword(s):  
Mortality Rate ◽  
Average Length ◽  
Wound Care ◽  
Length Of Hospital Stay ◽  
Fournier’S Gangrene ◽  
Concomitant Disease ◽  
Perianal Region ◽  
Fournier's Gangrene ◽  
War Wounds ◽  
Fournier Gangrene

Background: Fournier's gangrene (FG) is a specific form of necrotizing fasciitis seen in the external genital organs and perianal region. The basic management of Fournier's gangrene is based on critical surgical debridement. Dakin's solution (sodium hypochlorite) was originally developed to treat war wounds. In this study, we aimed to show potentially efficient of Dakin’s solution on wound healing and reoperation rate.Methods: Thirty-three patients who were debrided due to Fournier Gangrene during 2012-2020 were included in the study. After debridement, wound care was done twice a day by dressing with a sponge moistened with Dakin's solution. Patients' age, concomitant disease, involvement site, re-debridement requirement, complications, and discharge times were recorded.Results: The mean age of 33 male patients who participated in the study was (51-74) 63.93±15.36. Although all patients had scrotal involvement, nine patients had perineal (27.2%), 12 patients had inguinal (36.3%), four patients had a penis and pubic spread (12.1%). The mortality rate was 6%. The average length of hospital stay was 13.1±4.2 days, and the average number of debridements was 1.Conclusions: Fournier gangrene is an important disease characterized by necrotizing infection of the genital, perineal, and perianal region and progresses with high mortality. Our mortality rate was lower than literature and we have linked our mortality rate to using Dakin's solution for wound care. Dressing with Dakin's solution is an effective and reliable method for wound care in FG patients.

Gangrena de Fournier. Reporte de caso

2020 ◽  
Vol 63 (5) ◽  
pp. 26-30
Author(s):  
Paloma Pérez Ladrón de Guevara ◽  
Georgina Cornelio Rodríguez ◽  
Oscar Quiroz Castro
Keyword(s):  
Mortality Rate ◽  
Necrotizing Fasciitis ◽  
Broad Spectrum ◽  
Soft Tissues ◽  
Fournier’S Gangrene ◽  
Type Ii ◽  
Necrotic Tissue ◽  
Fournier's Gangrene ◽  
Necrotizing Fascitis ◽  
Key Words Fournier's Gangrene

Fournier’s Gangrene is a type II necrotizing fascitis that leads to thrombosis of small subcutaneous vessels and spreads through the perianal and genital regions and the skin of the perineal. Most cases have a perianal or colorectal focus and in a smaller proportion it originates from the urogenital tract. The mortality rate varies between 7.8 and 50%1-3, only timely diagnosis decreases the morbidity and mortality of this condition. Treatment includes surgical debridement of all necrotic tissue and the use of broad-spectrum antibiotics. Key words: Fournier’s gangrene; gangrene; necrotizing fasciitis; infectious necrotizing of soft tissues.

scholarly journals Fournier’s gangrene: a retrospective review of management outcomes and seasonal variations of clinical presentation

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Ikenna I. Nnabugwu ◽  
Okechukwu O. Onumaegbu ◽  
Louis T. Okolie
Keyword(s):  
Hospital Admission ◽  
Seasonal Variations ◽  
Medical Records ◽  
Vital Signs ◽  
Skin Grafting ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Management Interventions ◽  
Split Skin Grafting

Abstract Background To review retrospectively the outcomes of management of Fournier’s gangrene (FG) and to assess for possible seasonal variations in clinical presentations of FG to a referral hospital in a tropical African country. Methods The medical records of patients who presented with FG from February 2012 to December 2019 were reviewed. Of interest were age of patient, vital signs at presentation, site of gangrene, duration of hospital admission, and management interventions deployed. Analysis was with SPSS® version 21. Results Twenty-three of 28 medical records could be analyzed. Median Fournier’s Gangrene Severity Index (FGSI) was 5 (IQR:3–10), the median Uludag-FGSI (UFGSI) was 7 (IQR:4–14). In 82.6%, the scrotum was the site of onset; in 8.7%, the lesion had spread beyond the pelvis. Diabetes mellitus (30.4%), HIV infection (13.0%) and nephropathy (17.4%) were identified co-morbidities. There were 2.4 ± 1.0 debridement sessions and 1.5 ± 1.3 transfused units of blood per patient. In 60.9%, the wound edges were undermined and apposed; in 17.4%, split skin grafting or fascio-cutaneous flap cover was deployed. In 17.4%, satisfactory wound closure needed more than 1 theater session. Mean duration of hospital admission was 51.4 ± 19.4 days. No mortality was recorded. Majority (91.2%) presented in hot, dry months of October through March with peak in December. No case presented in the wet months of May through September. Conclusion Meager resources notwithstanding, FG management outcomes are generally satisfactory. Furthermore, FG is observed to present mostly in the hot, dry months of the year in the 8 years under review.

MICROBIOLOGICAL PROFILE, ANTIBIOTIC SENSITIVITY AND PROGNOSIS OF PATIENTS WITH FOURNIER’S GANGRENE: A PROSPECTIVE, HOSPITAL BASED STUDY FROM NORTH INDIA

2021 ◽  
pp. 78-80
Author(s):  
Sanjay Gupta ◽  
Ajay Kumar ◽  
Adiveeth Deb
Keyword(s):  
Mortality Rate ◽  
Acinetobacter Baumannii ◽  
Ventilatory Support ◽  
Antibiotic Sensitivity ◽  
Fournier’S Gangrene ◽  
North India ◽  
Klebsiella Pneumonia ◽  
Bacterial Strains ◽  
Perianal Region ◽  
Fournier's Gangrene

Background: Fournier's gangrene (FG) is a devastating disease that is characterized by necrotizing fasciitis of the perineal, genital, or perianal region. Broad-spectrum antibiotics are the key component of its treatment. However, there is paucity of data regarding the optimal empirical antibiotic therapy for FG. Materials and Methods: Data from patients who underwent surgery for FG was retrieved from a prospectively collected departmental FG database. Demographics, clinical characteristics, causative pathogens and drug susceptibility/resistance were evaluated. Outcome was also assessed in terms of mortality. Results: Fifty patients with a median age of 58.5 (40-83) years were included. The perianal region and scrotum (88%) were the most commonly affected. Diabetes mellitus (DM) was the most common comorbidity (92%). The median time to onset of symptoms was 7 (2-15) days, and the median duration of hospital stay was 22 (4-65) days. Ventilator requirement was required in 15 (30%) patients. The median UFGSI score was 9.5 (3-15). The overall mortality rate was 26%. A positive growth was found in specimen cultures of 48 (96%) patients. The median number of bacterial strains that grew in the cultures was 3 (0-10). Amikacin was the antibiotic with the highest frequency of sensitivity (74%), while the highest resistance was observed against ampicillin-sulbactam (64%). Escherichia coli was the most common microorganism (68%). Acinetobacter baumannii and Klebsiella pneumonia were signicantly more common in patients who required mechanical ventilation. The mortality rate was 26%. An Uludag Fournier's Gangrene Severity Index (UFGSI) score of > 9.5 and ventilatory support requirement were factors associated with an increased rate of mortality. Acinetobacter baumannii was the only microorganism which was associated with an increased mortality rate. Conclusion: Causative pathogens in FG appeared to be shifting; thus, empirical antibiotic treatment for this disease should be modied. We recommend 3rd-generation cephalosporin, metronidazole and amikacin for empirical therapy.

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