FOURNIER’S GANGRENE – SURGICAL CONSIDERATIONS
Fournier’s gangrene (FG) is a galloping form of necrotizing infectious fasciitis located in the perineal, genital or perianal regions. Methods: The medical records of 10 patients with FG between 01 January 2003 to 31 January 2020 who presented in the Emergency Department at the St. Spiridon University Hospital Iasi were reviewed retrospectively. Results: All patients were males, with a mean age 51 years (range 24 years–78 years). One of the most common predisposing factors was diabetes. The mean time of symptoms prior to referral to treatment was 11 days, ranging from 4 days to 25 days. We performed a radical surgical debridement, requiring up to 5 surgical interventions consisted of excision of all necrotic tissue. In 3 patients (30%) after initial radical debridement, underwent loop colostomy for fecal diversion. Orchiectomy was performed unilaterally for gangrenous testis in one case. We registered mortality in 2 cases with FG extended to the abdominal wall. Conclusions: FG is still a fulminant disease, with a high mortality rate and prolonged hospitalization. Prognostic factors for mortality are advanced age, renal failure, extension to the abdominal wall, septic shock, and postoperative mechanical ventilation. Early diagnosis and aggressive treatment are essential for a good prognosis.
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