fournier's gangrene
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Cureus ◽  
2022 ◽  
Enkhmaa Luvsannyam ◽  
Sataj Johnson ◽  
Veronica Velez ◽  
Archana Bottu ◽  
Tasanee Rungteranoont ◽  

2021 ◽  
Vol 8 ◽  
Luke Taylor ◽  
Omar Asmar ◽  
Anirban Mandal ◽  
Ascanio Tridente ◽  
Kevin Hardy ◽  

Introduction: The recent report issued by the MHRA indicating an association of Sodium glucose linked transporter type 2 (SGLT2) Inhibitors with the contraction of Fournier's Gangrene (FG), has been drawn with insufficient supporting evidence and without an adequately powered study to make any meaningful assertions or recommendations. We aimed to look specifically at the currently available dataset used to link SGLT2 Inhibitors to FG and highlight what conclusions or inferences can meaningfully be made, in particular the power of any study that would be required to make sensible conclusions.Methods: World literature review of SGLT2 Inhibitors and FG was performed. With a subsequent 10-year review of cases of FG seen in a regional burns and plastics centre. Data was collected retrospectively from the coding department at Whiston Hospital for all patients with necrotising fasciitis. An electronic document management system was used to identify patients with FG specifically as well as their diabetes state and medication history.Results: Seventy-eight patients were admitted with FG, of whom 32 had diabetes mellitus (DM). Of those with DM none was taking an SGLT2 Inhibitor, 17 patients were taking metformin, a further nine patients were taking a second line medication and 14 required insulin injections.Discussions: DM is a known major risk factor for FG, which is clearly observed in our patient cohort. The risk of patients with DM developing FG is irrespective of the medication patients are taking. The current articles and reports published have little ground to claim an association between SGLT2 Inhibitors and FG and are missing the crucial message that needs to be conveyed to the public: that DM is a major risk factor for FG and patients suffering with diabetes need to be extra vigilant.

2021 ◽  
Vol 27 (1) ◽  
Oluwatosin Stephen Ilori ◽  
David. A. Onilede ◽  
Ademola. A. Popoola ◽  
Olorunnisola O. Olatide ◽  
Chidi O. Ugwuoke

Abstract Background Fournier’s gangrene is an acute soft tissue necrotizing infection involving the perineum and the external genitalia which can result in a major loss of the scrotal wall with exposure of the testicles. Reconstruction of such major defect is quite challenging; the use of pedicled gracilis muscle flap helps to create an aesthetically acceptable scrotum with minimal donor site morbidity. Case presentation We described the case of a 60-year-old man with a large scrotal loss from Fournier’s gangrene following bladder outlet obstruction and perineal abscess. He had multiple debridement and reconstruction with pedicled left gracilis muscle flap with a good aesthetic and functional post-operative outcome. The major challenge encountered was the loss of the skin graft as a result of the retraction of the muscle flap due to too early ambulation; this can thus be avoided by adequate pre-operative counseling and enforcing bed rest. Conclusions The use of gracilis muscle flap in the reconstruction of large scrotal defect described in this report has the additional advantage of creating a pliable and soft feel like that of the original scrotum with minimal donor site morbidity.

2021 ◽  
pp. 51-62
Grigory Vladimirovich Rodoman ◽  
Sergej Kensarinovich Zyrjanov ◽  
Gleb Aleksandrovich Pucman ◽  
Marina Aleksandrovna Ivzhits ◽  
Leonid Vladimirovich Kornev ◽  

The article describes a clinical case of Fournier’s gangrene in a 65-year-old man with rectal mucinous adenocarcinoma. Given the presence of a malignant neoplasm, elderly age and the general severity of the patient’s condition, the widest empirical antibiotic therapy was prescribed, the spectrum of which overlapped the most probable pathogens. The patient was discharged from the hospital on the 32nd day. The article discusses the rational tactics of antimicrobial therapy in such difficult cases for treatment.

José López-Fernández ◽  
Gabriel García Plaza ◽  
Ismael Antón Fernández

2021 ◽  
pp. 004947552110480
Okoro Philemon E ◽  
Igwe Promise W ◽  
Alinnor Ezioma A ◽  
Okoro Chinwendu A ◽  
Nwiwu Princewill

Fournier’s gangrene (FG), a necrotizing fasciitis of the genital and perineal region, is a serious and debilitating multi-infective pathological condition. More commonly seen in adults, its occurrence in neonates is uncommon. We share our experience with neonatal FG (NFG), highlighting potential factors which may predispose neonates to it. Ours is a five year retrospective review of cases of NFG in our service. Data obtained included health facility of birth, mode of delivery, symptoms and duration, investigation results, treatment and outcome. Sixteen neonates were included, comprising 13 males (M:F  =  4.3:1). Fourteen were delivered outside our centre; breech vaginal delivery, hot water massaging and application of native concoctions were common. All were treated with antibiotics and wound debridement, but five (37.5%) died.NFG is not that rare in our service. Early recognition is imperative to reduce mortality. Neonates delivered by breech vaginally may be particularly at risk.

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