Incorporating Simplified Fournier's Gangrene Severity Index with early surgical intervention can maximize survival in high‐risk Fournier's gangrene patients

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.

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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

Actas Urológicas Españolas (English Edition) ◽

10.1016/j.acuroe.2011.01.007 ◽

2011 ◽

Vol 35 (6) ◽

pp. 332-338 ◽

Cited By ~ 3

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

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

Aktuelle Urologie ◽

10.1055/a-1260-2576 ◽

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.

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The evaluation of microbiology and Fournier's gangrene severity index in 27 patients

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2009.01.021 ◽

2009 ◽

Vol 13 (6) ◽

pp. e424-e430 ◽

Cited By ~ 21

Author(s):

Mehmet Uluğ ◽

Ercan Gedik ◽

Sadullah Girgin ◽

Mustafa K. Çelen ◽

Celal Ayaz

Keyword(s):

Severity Index ◽

Fournier’S Gangrene ◽

Fournier's Gangrene

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

Canadian Urological Association Journal ◽

10.5489/cuaj.3192 ◽

2015 ◽

Vol 9 (11-12) ◽

pp. 800 ◽

Cited By ~ 8

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.

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122: The Fournier’s Gangrene Severity Index for Predicting Outcome of the Disease: Is it Useful?

The Journal of Urology ◽

10.1016/s0022-5347(18)37384-1 ◽

2004 ◽

Vol 171 (4S) ◽

pp. 32-32

Author(s):

Eugene Lin ◽

Stone Yang ◽

Hsi-Hsien Hsu ◽

Yung-Chiong Chow

Keyword(s):

Severity Index ◽

Fournier’S Gangrene ◽

Fournier's Gangrene ◽

Predicting Outcome

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Anoplasty For Fused Anus Following Fournier’s Gangrene Debridement: A Case Report

10.21203/rs.3.rs-239976/v1 ◽

2021 ◽

Author(s):

Jothinathan Muniandy ◽

Fitjerald Henry ◽

Yong Sim Teh

Keyword(s):

Surgical Intervention ◽

Learning Experience ◽

Fournier’S Gangrene ◽

Anal Stenosis ◽

Success Rates ◽

Fournier's Gangrene ◽

Management Options ◽

Initial Recovery ◽

Management Challenge ◽

Surgical Condition

Abstract Anal stenosis is a rare debilitating surgical condition. The severity and level of the impacted region determines the management options. Numerous tension free anoplasty techniques and its varying success rates have been reported. A patient-tailored anoplasty approach depending on the severity, location, and extent of anal stenosis is rudimentary. We present a case of fused anus following extensive surgical debridement for Fournier’s Gangrene. Colonoscopy illumination guided neo-anal creation was performed, which resulted in low severe anal stenosis six weeks later. Subsequently, Y-V anoplasty, lateral internal sphincterotomy, and colostomy closure were done which showed good initial recovery. However, six months later, the anal stenosis recurred, for which diamond-shaped anoplasty was offered but patient had refused any further surgical intervention. The clinical management challenge and learning experience is shared within the report.

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