Fournier’s Gangrene: Our Clinical Experience and Outcomes

Yıl 2022, Cilt: 8 Sayı: 1, 123 - 129, 25.02.2022

İbrahim Yazıcı , Erdal Benli , Abullah Çırakoğlu , Ahmet Yüce , Nurullah Kadim , Mevlüt Keleş

https://doi.org/10.19127/mbsjohs.1035310

Öz

Objective: We aimed to present our results and experience related to patients followed with Fournier’s gangrene.
Methods: Patient data were retrospectively obtained from patient records. Data from 10 patients attending Ordu University Education-Research Hospital Urology clinic with diagnosis of Fournier’s gangrene from April 2017 to April 2021 were used. Cases developing after surgery, with compression wounds, and related to radiotherapy were excluded. Information like patient history, demographic features, comorbid diseases, physical examination findings and treatment outcomes were recorded.
Results: The study included outcomes for 10 patients. Mean age was identified as 71.50±9.09 (51-78) years. All of our patients were male, with no female patient among our cases. Mean body weight of patients was 80.40±1.81 (78-83) kg. When patients are assessed in terms of substance use, 60% of patients smoked and 10% drank alcohol. The mean total number of medications used due to comorbid diseases was 1.8 (0-6). The mean ASA score for patients was 2.20±0.42. In terms of initial location, 6 patients had lesions in the scrotum (60%), 1 on the penis (10%) and 3 in the perineal region (30%). The mean duration until surgery was 8.71±4.95 (3-17) days, with mean number of surgeries after diagnosis 1.67±0.81 (1-3), and mean dressing duration 22.14±5.30 (15-30) days (Table 1). Pathology results for one patient identified squamous cell cancer (10%).
Conclusion: In spite of all developments, Fournier’s gangrene is still an emergency situation associated with high levels of morbidity and mortality. In clinics experienced with this disease, it may be treated close to perfectly with high success rates and low complication rates. We believe the most important points for treatment are early diagnosis, effective.

Anahtar Kelimeler

Fournier’s gangrene, debridement, experience

Fournier’s Gangrene: Our Clinical Experience and Outcomes

Öz

Objective: We aimed to present our results and experience related to patients followed with Fournier’s gangrene.
Methods: Patient data were retrospectively obtained from patient records. Data from 10 patients attending Ordu University Education-Research Hospital Urology clinic with diagnosis of Fournier’s gangrene from April 2017 to April 2021 were used. Cases developing after surgery, with compression wounds, and related to radiotherapy were excluded. Information like patient history, demographic features, comorbid diseases, physical examination findings and treatment outcomes were recorded.
Results: The study included outcomes for 10 patients. Mean age was identified as 71.50±9.09 (51-78) years. All of our patients were male, with no female patient among our cases. Mean body weight of patients was 80.40±1.81 (78-83) kg. When patients are assessed in terms of substance use, 60% of patients smoked and 10% drank alcohol. The mean total number of medications used due to comorbid diseases was 1.8 (0-6). The mean ASA score for patients was 2.20±0.42. In terms of initial location, 6 patients had lesions in the scrotum (60%), 1 on the penis (10%) and 3 in the perineal region (30%). The mean duration until surgery was 8.71±4.95 (3-17) days, with mean number of surgeries after diagnosis 1.67±0.81 (1-3), and mean dressing duration 22.14±5.30 (15-30) days (Table 1). Pathology results for one patient identified squamous cell cancer (10%).
Conclusion: In spite of all developments, Fournier’s gangrene is still an emergency situation associated with high levels of morbidity and mortality. In clinics experienced with this disease, it may be treated close to perfectly with high success rates and low complication rates. We believe the most important points for treatment are early diagnosis, effective.

Anahtar Kelimeler

Fournier’s gangrene, debridement, experience

Kaynakça

• 1. Grzybowski A. A short history of Fournier gangrene. Arch Dermatol. 2009;145(2):182.
• 2. Sallami S, Maalla R, Gammoudi A, Ben Jdidia G, Tarhouni L, Horchani A. Fournier's gangrene: what are the prognostic factors? Our experience with 40 patients. Tunis Med. 2012;90(10):708-14.
• 3. Thwaini A, Khan A, Malik A, Cherian J, Barua J, Shergill I, Mammen K. Fournier's gangrene and its emergency management. Postgrad Med J. 2006;82(970):516-9.
• 4. Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg. 2000;87(6):718-28.
• 5. Çalışkan S, Özsoy E, Sungur M, Gözdaş HT. Fournier's gangrene: Review of 36 cases. Ulus Journal of Trauma Emergency Surgery 2019;25(5):479-483.
• 6. Singh A, Ahmed K, Aydin A, Khan MS, Dasgupta P. Fournier's gangrene. A clinical review. Arch Ital Urol Androl. 2016;88(3):157-164.
• 7. Taviloglu K, Cabioglu N, Cagatay A, Yanar H, Ertekin C, Baspinar I, Ozsut H, Guloglu R. Idiopathic necrotizing fasciitis: risk factors and strategies for management. Am Surg. 2005;71(4):315-20.
• 8. Korkut M, Icoz G, Dayangac M, Akgun E, Yeniay L, Erdogan O, Cal C. Outcome analysis in patients with Fournier's gangrene: report of 45 cases. Dis Colon Rectum. 2003;46(5):649-52.
• 9. Kamper L, Piroth W, Haage P. Fournier-Gangrän mit letalem Verlauf bei einer Patientin mit Diabetes mellitus [Fournier gangrene (necrotizing fasciitis) in a woman with diabetes mellitus]. Dtsch Med Wochenschr. 2009 Aug;134(33):1625-8. German.
• 10. Fajdic J, Gotovac N, Hrgovic Z. Fournier gangrene: our approach and patients. Urol Int. 2011;87(2):186-91.
• 11. Malik AM, Sheikh S, Pathan R, Khan A, Sheikh U. The spectrum of presentation and management of Fournier's gangrene--an experience of 73 cases. J Pak Med Assoc. 2010;60(8):617-9.
• 12. Korhonen K, Hirn M, Niinikoski J. Hyperbaric oxygen in the treatment of Fournier's gangrene. Eur J Surg. 1998;164(4):251-5.
• 13. Mindrup SR, Kealey GP, Fallon B. Hyperbaric oxygen for the treatment of fournier's gangrene. J Urol. 2005;173(6):1975-7.
• 14. Chernyadyev SA, Ufimtseva MA, Vishnevskaya IF, Bochkarev YM, Ushakov AA, Beresneva TA, Galimzyanov FV, Khodakov VV. Fournier's Gangrene: Literature Review and Clinical Cases. Urol Int. 2018;101(1):91-97.