scholarly journals Penile reconstruction with dermal template and vacuum therapy in severe skin and soft tissue defects caused by Fournier's gangrene and hidradenitis suppurativa

2014 ◽  
Vol 13 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Ingo Ludolph ◽  
Torsten Titel ◽  
Justus P. Beier ◽  
Adrian Dragu ◽  
Marweh Schmitz ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hidradenitis Suppurativa ◽  
Fournier’S Gangrene ◽  
Vacuum Therapy ◽  
Soft Tissue Defects ◽  
Fournier's Gangrene ◽  
Dermal Template ◽  
Tissue Defects

scholarly journals A clinical study of management of Fournier’s gangrene in a rural hospital

2018 ◽  
Vol 5 (4) ◽  
pp. 1524
Author(s):  
Purushotham T. Shivaraju ◽  
Ponnappa B. Ganapathy ◽  
Naveen N. ◽  
Pruthvika N.
Keyword(s):  
Soft Tissue ◽  
Hospital Stay ◽  
External Genitalia ◽  
Fournier’S Gangrene ◽  
Surgical Reconstruction ◽  
Reconstructive Procedure ◽  
Soft Tissue Defects ◽  
Fournier's Gangrene ◽  
Wound Debridement ◽  
Tissue Defects

Background: Fournier’s gangrene is a potentially life threatening synergistic necrotising fascitis of external genitalia and perineal tissues. It commonly affects young men but can also affect women and children. The use of broad spectrum antibiotics and serial wound debridement is the main stay of treatment. The reconstruction of soft tissue defect following the debridement is a challenging task. The purpose of this study is to evaluate the surgical reconstruction methods of soft tissue defects due to Fournier's gangrene.Methods: This was a prospective study conducted in Adichunchanagiri Institute of Medical Sciences from January 2015 to December 2017. All patients with necrotizing fascitis of external genitalia and perineum, irrespective of age and gender, were included. Parameters such as age, gender, aetiology, predisposing factors, clinical features, defect location, type of bacterial flora, sort of reconstructive procedure used, and duration of hospital stay, post-operative pain, patient satisfaction and mortality, if any, were studied. The choice of reconstructive procedure was based on severity of defect, availability of local tissue and patient preference.Results: Out of 31 cases included in the study, 30 patients underwent reconstructive procedures. The age range was 4 to 74 years (mean 38.5). The commonest presentation was pain, scrotal swelling and fever. The most common aetiology was urogenital diseases. 10 patients were treated by split-thickness skin graft, 5 by secondary suturing, 2 by unilateral superomedial thigh flap, 4 by bilateral superomedial thigh flap, 5 by tensor fascia lata flap, 2 by medial thigh V-Y advancement flap, 2 with perineal artery flap and one case healed by secondary intention.Conclusions: This study suggests that earlier presentation, with early diagnosis and intervention with prompt debridement and appropriate, appropriate antibiotics are the main stays of treatment. The resulting soft tissue defects following wound debridement required surgical reconstruction, except in one case, thus decreasing morbidity, hospital stay and early return of patients to regular life.

scholarly journals A Rare Case of Idiophatic Fournier’s Gangrene: Scrotal Reconstruction via Anterolateral Thigh Flap

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110289
Author(s):  
Tomas Mačiulaitis ◽  
Nerijus Jakutis ◽  
Karolis Baužys
Keyword(s):  
Unusual Case ◽  
Treatment Plan ◽  
Fournier’S Gangrene ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Healthy Male ◽  
Fournier's Gangrene ◽  
Anterolateral Thigh ◽  
Scrotal Reconstruction ◽  
Tissue Defects

Fournier’s gangrene (FG) is a surgical emergency. The main treatment plan for this disease includes several aggressive debridements, which lead to the development of massive soft-tissue defects in the affected area. Current literature describes various possible reconstructive options for the closure of those defects, yet, there is no evidence on which is the most efficient. Here we describe an unusual case of an otherwise healthy male presenting with a scrotal Fournier’s gangrene. In our case, the reconstruction was performed via anterolateral thigh flap. Due to a postoperative complication the flap was partly lost, however, consequences were managed successfully and a satisfactory result was achieved.

scholarly journals EXPERIENCE OF USING NPWT-THERAPY IN THE TREATMENT OF COMBAT INJURIES OF SOFT TISSUES OF THE LIMBS AND BODY

2021 ◽  
pp. 56-60
Author(s):  
Ya. I. Haida ◽  
K. R. Muradian ◽  
S. V. Petrushenko ◽  
O. S. Herasymenko ◽  
A. V. Okolets
Keyword(s):  
Soft Tissue ◽  
Granulation Tissue ◽  
Negative Pressure ◽  
Soft Tissues ◽  
Variable Pressure ◽  
Comprehensive Treatment ◽  
Vacuum Therapy ◽  
Soft Tissue Defects ◽  
Combat Injuries ◽  
Tissue Defects

Summary. Aim. NPWT-therapy (Negative-pressure wound therapy) or VAC-therapy (Vacuum Assisted Clousur) - a modern method of wound healing, which significantly improves the course of all stages of the wound process and is relevant today due to the large number of wounded during hostilities in eastern Ukraine. Often these injuries are combined and lead to the formation of large soft tissue defects. The aim of the study. Improving the results of treatment of the wounded with extensive defects of the soft tissues of the torso and extremities through the use of NPWT therapy. Materials and methods. Under our supervision in the period from 2017 to 2020 there were 60 wounded who were hospitalized in the surgical departments of the Military Medical Clinical Center of the Southern Region, who received vacuum therapy in the treatment of wounds. 38 (63.3%) had gunshot wounds to the extremities, and 22 (36.7%) had soft tissue injuries to the torso. The age of the wounded ranged from 19 to 58 years, among them young people under 30 years of age. Before installing the device, it was necessary to perform surgical treatment with excision of necrotic tissue and removal of fibrin layers. Negative pressure was set at -125 mm Hg. Art. in the non-stop mode for soft tissue defects of the extremities and variable pressure in the -40 mm Hg mode. Art. -70 mm Hg Art. for wounds of the anterior abdominal wall. The duration of treatment with NPWT therapy was from 5 to 25 days. The systems were replaced at least once every 3-5 days. Criteria for discontinuation of NPWT therapy were: cleansing the wound of necrotized tissues and fibrin, improving clinical performance, filling the wound defect with granulation tissue. Results and discussion. The use of this method of treatment allowed to close wound defects by autodermoplasty in 21 patients (35%), primary-delayed sutures in 11 (18%), secondary sutures in 15 (25%) and local tissue plastics in 13 (22%). Complications after NPWT therapy in the form of re-suppuration of the wound, bleeding or perforation of hollow organs and large vessels were not observed. Conclusions. The use of NPWT therapy can significantly increase the effectiveness of comprehensive treatment of the wounded with damage to the soft tissues of the torso and extremities. It allows you to quickly clean the wound surface, fill the wound defect with granulation tissue and prepare the wound for plastic closure.

Fournier gangrene – ward experience

Nowa Medycyna ◽  
2018 ◽  
Vol 25 (3) ◽  
Author(s):  
Zbigniew Tański ◽  
Zbigniew Jarząbek ◽  
Bartosz Konowalski ◽  
Maciej Truszkowski ◽  
Jakub Biedrzycki ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Rapid Onset ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Fournier Gangrene ◽  
Final Treatment ◽  
Co Morbidity ◽  
Life Threatening ◽  
Treatment Procedures ◽  
Tissue Defects

Introduction. Fournier’s gangrene is a necrotising soft-tissue infection characterized by insidious and rapid onset. It belongs to the group of necrotising soft-tissue infections. The disease is more common in patients with systemic predispositions such as diabetes mellitus, obesity, hepatic cirrhosis, cancer, etc. Aim. The results of medical treatment thirtieths patients (man from 34 to 84 years old, middle age 67 years old) and co-morbidity with Fournier’s gangrene was presented. Material and methods. The co-morbidity was discussed and analized. The patients were treated by antishock therapy, proper antibiotic therapy was applied. The complications were presented during treatment, procedures with wounds, debridement and wounds treatment and final treatment skin deficiency. All patients had covered skin deficiency by mesh grafts, they were discharged from hospital with healed wounds or almost healed. Treatment from medical literature dealing with treatment and experience of Urological Wards was also presented (Fournier’s gangrene is a part of this disease). Results. Mortality was not observed in this group of patients. Conclusions. Fournier’s gangrene is a rapid-onset, life-threatening, acute urological disease requiring immediate diagnosis, as well as anti-shock and antibacterial therapy combined with intensive surgical debridement followed by the management of skin and soft tissue defects.

Thoracic Propeller Perforator Flaps for Covering Soft Tissue Defects

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Matei Ileana ◽  
Alexandru Georgescu ◽  
Radu Lacatus ◽  
Manolis Daskalakis
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Tissue Defects
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