Hyperbaric oxygen therapy adjunctive to surgical debridement in management of Fournier's gangrene: Usefulness of a severity index score in predicting disease gravity and patient survival

2011 ◽  
Vol 35 (6) ◽  
pp. 332-338 ◽  
Author(s):  
A. Janane ◽  
F. Hajji ◽  
T.O. Ismail ◽  
J. Chafiqui ◽  
M. Ghadouane ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Patient Survival ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Index Score ◽  
Surgical Debridement ◽  
Fournier's Gangrene ◽  
Severity Index Score

Hyperbaric Oxygen Therapy as an Adjuvant Therapy for Comprehensive Treatment of Fournier's Gangrene

2015 ◽  
Vol 94 (4) ◽  
pp. 453-458 ◽  
Author(s):  
Chao Li ◽  
Xu Zhou ◽  
Long-Fei Liu ◽  
Fan Qi ◽  
Jin-Bo Chen ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Conventional Therapy ◽  
Oxygen Therapy ◽  
Fournier’S Gangrene ◽  
Surgical Debridement ◽  
Drainage Tube ◽  
Comprehensive Treatment ◽  
Fournier's Gangrene ◽  
Multicenter Studies

Objectives: To compare simple conventional treatment with the addition of hyperbaric oxygen therapy (HBOT) to conventional therapies in the treatment of Fournier's gangrene (FG). Methods: A retrospective study of clinical data was performed by reviewing 28 cases of FG from January 2004 to December 2013 at Xiangya Hospital, Central South University. Among them, 12 patients were treated with the conventional therapy (non-HBOT group) and the other 16 cases were combined with hyperbaric oxygen therapy besides conventional therapy (HBOT group). All patients were followed up for 2 months to assess the therapeutic effect. The analyzed data included age, Fournier gangrene severity index (FGSI) score, number of surgical debridement, indwelling drainage tube time, length of stay (LOS), effective time, and curative time. Results: The mortality rate was lower in the HBOT group at 12.5% (2/16) compared to the non-HBOT group, which was 33.3% (4/12). The difference in the number of surgical debridement, indwelling drainage tube time, and curative time between were significantly lower in the HBOT group compared to the non-HBOT group. Conclusions: Our preliminary research suggests that the effect of combining hyperbaric oxygen therapy with conventional therapy offers considerable advantage in the management of Fournier's gangrene. Multicenter studies with a larger sample size are required to confirm these observations.

Factors affecting length of stay in Fournier’s gangrene: a retrospective analysis of 10 years’ data

2020 ◽  
Author(s):  
Mithat Eksi ◽  
Yusuf Arikan ◽  
Abdulmuttalip Simsek ◽  
Osman Ozdemir ◽  
Serdar Karadag ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Severity Index ◽  
Mortality Rates ◽  
Fournier’S Gangrene ◽  
Index Score ◽  
Fournier's Gangrene ◽  
Wound Therapy ◽  
Severity Index Score

Abstract Background We aimed to investigate the parameters that have an effect on the length of stay and mortality rates of patients with Fournier’s gangrene. Material and Methods A retrospective review was performed on 80 patients who presented to the emergency department and underwent emergency debridement with the diagnosis of Fournier’s gangrene between 2008 and 2017. The demographic and clinical characteristics, length of stay, Fournier’s Gangrene Severity Index score, cystostomy and colostomy requirement, additional treatment for wound healing and the mortality rates of the patients were evaluated. Results Of the 80 patients included in the study, 65 (81.2 %) were male and 15 (18.7 %) female. The most common comorbidity was diabetes mellitus. The mean time between onset of complaints and admission to hospital was 4.6 ± 2.5 days. As a result of the statistical analyses, it was found that Fournier’s Gangrene Severity Index score, hyperbaric oxygen therapy, negative pressure wound therapy and the presence of sepsis and colostomy were significantly positively correlated with length of stay. Also it was found that the Fournier’s Gangrene Severity Index score, administration of negative pressure wound therapy and the presence of sepsis were correlated with mortality. Conclusion Fournier’s gangrene is a mortal disease and an emergency condition. With the improvements in Fournier’s gangrene disease management, mortality rates are decreasing, but long-term hospital stay has become a new problem. Knowing the values predicting length of stay and mortality rates can allow for patient-based treatment and may be useful in treatment choice.

scholarly journals The role of hyperbaric oxygen therapy in treating extensive Fournier's gangrene

2016 ◽  
Vol 27 (3) ◽  
pp. 148-153 ◽  
Author(s):  
Ming-Chan Hung ◽  
Chia-Lin Chou ◽  
Li-Chin Cheng ◽  
Chung-Han Ho ◽  
Ko-Chi Niu ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene

scholarly journals Hyperbaric Oxygen Therapy for the Treatment of Fournier’s Gangrene: A Review of 34 Cases

2015 ◽  
Vol 28 (5) ◽  
pp. 619 ◽  
Author(s):  
Isabel Rosa ◽  
Francisco Guerreiro
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Rare Condition ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Predisposing Factor ◽  
Source Of Infection ◽  
Clinical Records

<p><strong>Introduction:</strong> Fournier’s gangrene is a serious necrotizing infection that can be fatal if not promptly attended. Treatment for this condition consists of a combination of surgical debridement, antibiotherapy and supportive care. Hyperbaric oxygen therapy is used as an adjuvant for the optimization of infected tissue oxygenation and for its bactericidal and bacteriostatic effects.<br /><strong>Material and Methods:</strong> The data presented in this study encompass a period of 25 years of clinical records of patients with Fournier’s gangrene that had been treated at our center with hyperbaric oxygen therapy.<br /><strong>Results:</strong> A total of 34 patients were treated. The vast majority of patients were males (94.1%) with a mean age of 53.7 years. Urinary tract was the most frequent source of infection and diabetes was most common comorbidity seen in patients. Mortality rate was 20.8%.<br /><strong>Discussion:</strong> The most common observed comorbidity was diabetes, suggesting diabetes as one predisposing factor. The majority of deceased patients had diabetes, although no significant correlation between diabetes and death was found. The area of residence of patients may affect patients’ referral to these facilities.<br /><strong>Conclusions:</strong> Although Fournier’s gangrene is a rare condition, it is nevertheless a fatal illness, namely in patients with comorbidities like diabetes. Hyperbaric oxygen therapy is recommended as an adjuvant to conventional therapy and should be considered whenever available. To further assess the role of hyperbaric oxygen therapy, in the treatment of this condition, additional studies should be carried out.</p>

scholarly journals Hyperbaric oxygen therapy decreases mortality due to Fournier’s gangrene: a retrospective comparative study

2021 ◽  
Vol 11 (1) ◽  
pp. 18
Author(s):  
RogérioSerafim Parra ◽  
Omar Feres ◽  
MarleyRibeiro Feitosa ◽  
JoséJoaquim Ribeiro da Rocha ◽  
JulianaMamede Miranda ◽  
...  
Keyword(s):  
Comparative Study ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Retrospective Comparative Study

scholarly journals Treatment of Fournier's Gangrene with Combination of Vacuum-Assisted Closure Therapy, Hyperbaric Oxygen Therapy, and Protective Colostomy

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Giovanni Zagli ◽  
Giovanni Cianchi ◽  
Sara Degl'Innocenti ◽  
Jessyca Parodo ◽  
Lorenzo Bonetti ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Fournier’S Gangrene ◽  
Vacuum Assisted Closure ◽  
Fournier's Gangrene ◽  
Fournier Gangrene ◽  
Protective Colostomy

Fournier's gangrene is a rare process which affects soft tissue in the genital and perirectal area. It can also progress to all different stages of sepsis, and abdominal compartment syndrome can be one of its complications. Two patients in septic shock due to Fournier gangrene were admitted to the Intensive Care Unit of Emergency Department. In both cases, infection started from the scrotum and the necrosis quickly involved genitals, perineal, and inguinal regions. Patients were treated with surgical debridement, protective colostomy, hyperbaric oxygen therapy, and broad-spectrum antibacterial chemotherapy. Vacuum-assisted closure (VAC) therapy was applied to the wound with the aim to clean, decontaminate, and avoid abdominal compartmental syndrome development. Both patients survived and were discharged from Intensive Care Unit after hyperbaric oxygen therapy cycles and abdominal closure.

scholarly journals THE ROLE OF HYPERBARIC OXYGEN THERAPY IN FOURNIER'S GANGRENE: LITERATURE REVIEW

NSC Nursing ◽  
2021 ◽  
pp. 1-22
Author(s):  
Vincenza Giordano ◽  
Luca Cardillo
Keyword(s):  
Intensive Care ◽  
Literature Review ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Conventional Therapy ◽  
Oxygen Therapy ◽  
Research Question ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Beneficial Effects

Introduction: Fournier's Gangrene is a severe necrotising infection that can be fatal if not recognised and treated immediately. Treatment consists of a combination of conventional therapy with a multidisciplinary approach (early diagnosis, surgical debridement, antibiotic therapy, intensive care and reconstructive surgery) and adjuvant therapy with hyperbaric oxygen therapy sessions. Objective: To identify the role and evaluate the efficacy of hyperbaric oxygen therapy in Fournier's gangrene. Method: To conduct the following narrative review a research question was outlined using the PIO methodology. Subsequently, a literature review was conducted using the PubMed, Scopus and CINAHL Complete databases from December 2020 to February 2021. Results: Eight studies emerged from the literature review showing that the use of adjuvant Hyperbaric oxygen therapy (HBOT) in combination with classical treatment has beneficial effects and enhances the efficacy of hyperbaric oxygen therapy, resulting in lower mortality rates, in contrast to the average number of hospital days spent in intensive care, which do not undergo any significant change. But in contrast to mortality, the average number of days spent in intensive care differed significantly in favour of the standard treatment group. Conclusion: The combined effect of hyperbaric oxygen therapy with conventional therapy offers a significant advantage in the management of FG; furthermore, HBOT is associated with a significant survival advantage. Keywords: Fournier's gangrene, Fournier's disease, Hyperbaric oxygen therapy and HBOT

scholarly journals Fournier's gangrene

2008 ◽  
Vol 65 (10) ◽  
pp. 775-778
Author(s):  
Novak Milovic ◽  
Vladimir Bancevic ◽  
Zoran Campara ◽  
Branko Kosevic ◽  
Uros Zoranovic
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
External Genitalia ◽  
Fournier’S Gangrene ◽  
Necrotic Tissue ◽  
Comorbid Conditions ◽  
Fournier's Gangrene ◽  
Large Defect ◽  
Reconstructive Procedures

Background. Fournier's gangrene (FG) represents a necrotizing infection of the skin and subcutaneous soft tissue of the external genitalia and perineum. It arises as a result of propagation of anorectal, urogenital and skin infections. The principles of treatment include improving general condition of a patient, debridement of wound, excision of necrotic tissue, combined antibiotic therapy, hyperbaric oxygen therapy and reconstructive procedures. It is a rare but very serious condition which regardless to aggressive treatment can lead to a lethal outcome in up to 20-30% of patients. Case report. Since the year 2000 we have treated six patients with FG. We presented the course and positive treatment outcome in a 65- year-old male patient with numerous comorbid conditions, nonregulated insulin-dependent diabetes, hypertension, previous myocardial infarction, chronic viral hepatitis and thrombocytopenia, rehabilitation was complicated with heart failure, atrial fibrillation and pulmonary thromboembolism. The treatment consisted of two extensive debridement of the wound with removing necrotic tissue, drainage, consolidation of state of health, correction of his blood sugar levels and thrombocytopenia, antimycotic and combination of three antibiotics and hyperbaric oxygen therapy. In two delayed surgical procedures reconstruction of a large defect of the urethra was performed. Conclusion. A patient with numerous and serious comorbid conditions with FG could recover as a result of teamwork of urologists, infective medicine specialists, cardiologists, endocrinologist, vascular and plastic surgeons.

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