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.

scholarly journals Fournier's Gangrene Complicating Hematologic Malignancies: Literature Review and Treatment Suggestions

2013 ◽  
Vol 5 (1) ◽  
pp. e2013067 ◽  
Author(s):  
Giovanni D'Arena ◽  
Giuseppe Pietrantuono ◽  
Emilio Buccino ◽  
Giancarlo Pacifico ◽  
Pellegrino Musto
Keyword(s):  
Literature Review ◽  
Necrotizing Fasciitis ◽  
Clinical Course ◽  
Early Recognition ◽  
Severe Disease ◽  
External Genitalia ◽  
Hematologic Malignancies ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Appropriate Treatment

Fournier’s gangrene (FG) is a rare but severe necrotizing fasciitis of the external genitalia that may complicate the clinical course of hematologic malignancies and sometimes may be the first sign of the disease. The clinical course of FG is very aggressive and the mortality is still high despite the improvement in its management. Early recognition of FG and prompt appropriate treatment with surgical debridement and administration of antibiotics are the cornerstone of the management of this very severe disease.

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.

scholarly journals Fournier’s gangrene. A clinical review

2016 ◽  
Vol 88 (3) ◽  
pp. 157 ◽  
Author(s):  
Ariana Singh ◽  
Kamran Ahmed ◽  
Abdullatif Aydin ◽  
Muhammad Shamim Khan ◽  
Prokar Dasgupta
Keyword(s):  
Mortality Rate ◽  
High Mortality ◽  
Early Recognition ◽  
Care Pathway ◽  
Disease Process ◽  
Fournier’S Gangrene ◽  
Prognostic Indicators ◽  
Fournier's Gangrene ◽  
Randomized Controlled Studies ◽  
Clinical Awareness

Introduction and Hypothesis: Fournier’s gangrene is a rare, necrotising fasciitis of the external genitalia, perineal or perianal regions. The disease has a higher incidence in males and risk factors for development include diabetes, HIV, alcoholism and other immune-compromised states. The aggressive disease process is associated with a high mortality rate of 20-30%. In addition, the increasing age and prevalence of diabetes in the population, begs the need for increased clinical awareness of Fournier’s gangrene with emphasis on early diagnosis and management. This review aims to highlight the relevant research surrounding Fournier’s gangrene, in particular the various prognostic indicators and management strategies. Methods: A search was conducted on the MEDLINE database for all applicable research; clinical reviews, retrospective studies and case reports. In addition to which a search of the European Association of Urology, the British Association for Urological Surgeons and the British Medical Journal was conducted for the most recent recommendations. Results: Immediate broad-spectrum antibiotic therapy and urgent surgical debridement are the core managerial principles of Fournier’s gangrene. The use of adjunctive therapies such as hyperbaric oxygen and vacuum assisted closure are supported in some aspects of the literature and disputed in others. The lack of randomized controlled studies limits the use of these potential additional therapies to patients unresponsive to conventional management. The value of unprocessed honey as a topical antimicrobial agent has been highlighted in the literature for small lesions in uncomplicated patients. Conclusion: Fournier’s gangrene is a urological emergency with a high mortality rate despite advances in the medical and surgical fields. The aggressive nature of the infection advocates the need for early recognition allowing immediate surgical intervention. The opposing results of available research as well as the lack of high quality evidence surrounding emergent therapies prevents their routine use in the management of Fournier’s gangrene. The absence of a specific care pathway may hinder efficient management of Fournier’s gangrene, thus based on current guidelines a management pathway is suggested.

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.

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

Fournier's gangrene: Report on two cases

1997 ◽  
Vol 64 (2) ◽  
pp. 266-268
Author(s):  
F. Laganà ◽  
E. Cossaro ◽  
C. Ronconi ◽  
F. Sercia ◽  
M. Marchini
Keyword(s):  
Mortality Rate ◽  
Chronic Diseases ◽  
High Mortality ◽  
Hyperbaric Oxygenation ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Tissue Ischemia ◽  
First Choice

– Fournier's gangrene is a rare pathology that generally occurs in weakened patients with chronic diseases, like diabetes, which imply tissue ischemia and even today a high mortality rate. Two cases are presented, one of which is interesting for its pathogenesis. The authors confirm that first choice treatment should be surgical associated with antiobiotics and hyperbaric oxygenation whenever possible.

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