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.

The PAP Flap Breast Reconstruction: A Practical Option for Slim Patients

2021 ◽  
Author(s):  
Taehee Jo ◽  
Dong Nyeok Jeon ◽  
Hyun Ho Han
Keyword(s):  
Donor Site ◽  
Wound Dehiscence ◽  
Diep Flap ◽  
Separate Analysis ◽  
Flap Reconstruction ◽  
Average Body Mass Index ◽  
Deep Inferior Epigastric Perforator ◽  
Average Body Mass ◽  
Artery Perforator ◽  
Average Body

Abstract Background The posterior thigh-based profunda artery perforator (PAP) flap has been an emerging option as a secondary choice in breast reconstructions. However, whether a PAP flap could consistently serve as the secondary option in slim patients has not been investigated. Methods Records of immediate unilateral breast reconstructions performed from May 2017 to June 2019 were reviewed. PAP flap breast reconstructions were compared with standard deep inferior epigastric perforator (DIEP) flap breast reconstructions, and were grouped into single or stacked PAP flaps for further analysis. Results Overall, 43 PAP flaps were performed to reconstruct 32 breasts. Eleven patients underwent stacked PAP flap reconstruction, while 17 patients underwent 21 single PAP flap reconstruction. The average body mass index (BMI) of the patients was 22.2 ± 0.5 kg/m2. The results were as follows: no total loss, one case of venous congestion (2.3%), two donor site wound dehiscence cases (4.7%), and one case of fat necrosis from partial flap loss (2.3%). When compared with 192 DIEP flap reconstructions, the final DIEP flap supplied 98.1 ± 1.7% of mastectomy weight, while the final PAP flap supplied 114.1 ± 6.2% of mastectomy weight (p < 0.005), demonstrating that PAP flaps can successfully supply final reconstruction volume. In a separate analysis, single PAP flaps successfully supplied 104.2% (84.2-144.4%) of mastectomy weights, while stacked PAP flaps supplied 103.7% (98.8-115.2%) of mastectomy weights. Conclusion In our series of PAP flap reconstructions performed in low-to-normal BMI patients, we found that PAP flaps, as single or stacked flaps, provide sufficient volume to reconstruct mastectomy defects.

scholarly journals Changes in Adherence to the 24-Hour Movement Guidelines and Overweight and Obesity among Children in Northeastern Japan: A Longitudinal Study before and during the COVID-19 Pandemic

Obesities ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 167-177
Author(s):  
Hyunshik Kim ◽  
Jiameng Ma ◽  
Junghoon Kim ◽  
Daolin Xu ◽  
Sunkyoung Lee
Keyword(s):  
Environmental Changes ◽  
Preventive Measures ◽  
Overweight And Obesity ◽  
Health Programs ◽  
Average Body Mass Index ◽  
Northeastern Japan ◽  
Significant Difference ◽  
Community Health Programs ◽  
Average Body Mass ◽  
Average Body

There are few studies comparing adherence to Canadian 24-hour Movement Guidelines (24-h MG) before and during the COVID-19 pandemic and exploring the pandemic’s effect on childhood obesity. This survey-based 2-year study investigated changes in obesity and adherence to the 24-h MG in children before and during the COVID-19 pandemic. Data were collected at two points in time: pre-COVID-19 (May 2019; T1; n = 247) and during-COVID-19 (May 2021; T2; n = 171). Participants were healthy elementary school children aged between 6–12 years in northeastern Japan. The questionnaire comprised items on physical activity, screen time, sleep duration, adherence to the 24-h MG, and anthropometric and demographic characteristics. Among all participants, a statistically significant difference (p < 0.001) between the average body mass index at T1 (M = 16.06 kg/m2, SD = 2.08 kg/m2) and T2 (M = 18.01 kg/m2, SD = 3.21 kg/m2) was observed, where 17.8% were overweight and obese at T1 and 24% at T2, and 10.9% adhered to all 24 h MG at T1 and 4.1% at T2. To prevent obesity in children during the COVID-19 pandemic, environmental changes should be evaluated and appropriate preventive measures taken, including pro-community health programs that encourage parent-children outdoor activities.

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

Low prevalence of type 2 diabetes despite a high average body mass index in the aymara natives from chile

Nutrition ◽  
2001 ◽  
Vol 17 (4) ◽  
pp. 305-309 ◽  
Author(s):  
José Luis Santos ◽  
Francisco Pérez-Bravo ◽  
Elena Carrasco ◽  
Marcelo Calvillán ◽  
Cecilia Albala
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
Average Body Mass Index ◽  
Average Body Mass ◽  
Low Prevalence ◽  
Average Body

scholarly journals Predicting the birth of a large fetus in obese women

2020 ◽  
Vol 35 (4) ◽  
pp. 65-70
Author(s):  
I. V. Savelyeva ◽  
E. A. Bukharova ◽  
O. V. Shirokova ◽  
N. V. Nosova
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Body Mass ◽  
Continuous Variables ◽  
Obese Women ◽  
Average Body Mass Index ◽  
Normal Body Weight ◽  
Average Body Mass ◽  
Group 2 ◽  
Average Body

Purpose. To determine the risk of macrosomia in pregnant women as a function of body weight.Material and Methods. The study included 754 patients. All patients were divided into three groups. Group 1 included 262 obese patients with an average body mass index (BMI) of 33.1 (31.4; 35.9) kg/m2, aged 30 (27; 34) years. Group 2 comprised 260 overweight patients with an average body mass index of 27.5 (26.4; 28.7) kg/m2, aged 29 (25; 33) years. Group 3 (control) included 232 patients with normal body weight, BMI of 22.6 (21.0; 23.8) kg/m2, aged 28 (25; 31.5) years. Anthropometric data were assessed in all patients with the performance of general clinical and laboratory examinations.Results. Based on the results of logistic regression analysis for continuous variables, a prognostic model for the birth of a large fetus with a probability of up to 70.3% was constructed.

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.

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