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. 2017 Dec;14(6):1352-1358.
doi: 10.1111/iwj.12812. Epub 2017 Sep 25.

Prognostic factors and treatment outcomes for patients with Fournier's gangrene: a retrospective study

Kyung Sook Hong  1 , Hee Jung Yi  2 , Ryung-Ah Lee  2 , Kwang Ho Kim  2 , Soon Sup Chung  2
Affiliations

Prognostic factors and treatment outcomes for patients with Fournier's gangrene: a retrospective study

Kyung Sook Hong et al. Int Wound J. 2017 Dec.

Abstract

Fournier's gangrene is a gas-forming, necrotising soft tissue infection affecting the perineum. It spreads rapidly along the deep fascial planes and is associated with a high mortality rate. With a growing elderly population with comorbidities, the frequency of severe cases of Fournier's gangrene is expected to increase. We retrospectively reviewed 20 patients diagnosed with Fournier's gangrene at our institution from 2003 to 2014 and analysed data. Thirteen patients had diabetes mellitus, two had been diagnosed with liver cirrhosis, and four were chronic alcoholics. Of 15 patients admitted to an intensive care unit, 11 underwent colostomy, and 4 required skin grafts for wound healing. The wide wounds of two patients were healed using vacuum-assisted closure (VAC® ) dressing without additional surgery. The mortality rate was 25%, and the patients whose Fournier's gangrene severity index (FGSI) score was higher than 9 points or whose blood urea nitrogen (BUN) level was higher than 50 mg/dl had a poor prognosis. In order to treat Fournier's gangrene, aggressive surgical treatment, including wide debridement and stoma creation, should be considered as soon as possible to improve survival rates. Additionally, VAC dressing is helpful in healing the wide debridement wound without additional reconstructive surgery.

Keywords: Fournier's gangrene; negative-pressure wound therapy; soft tissue infection.

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Figures

Figure 1
Figure 1
A case of a patient with Fournier's gangrene. (A) Fournier's gangrene. Necrotic fasciitis spread to the perianal area and scrotum. (B) After debridement. Spontaneous orchiectomy was performed. (C) Reconstruction with skin graft. Skin defect was repaired with a skin graft from the left thigh.
Figure 2
Figure 2
Vacuum‐assisted closure (VAC®) dressing. (A) Necrotising fasciitis had spread to the suprapubic abdominal wall. (B) A vacuum‐assisted closure dressing was applied.
See this image and copyright information in PMC

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