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Review
. 2022 Mar 14;10(3):e4191.
doi: 10.1097/GOX.0000000000004191. eCollection 2022 Mar.

Practical Review of the Current Management of Fournier's Gangrene

Maria T Huayllani  1 , Amandip S Cheema  2 , Matthew J McGuire  3 , Jeffrey E Janis  1
Affiliations
Review

Practical Review of the Current Management of Fournier's Gangrene

Maria T Huayllani et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Fournier's gangrene is a fulminant disease. If diagnosed and treated early, mortality can be minimized, but morbidity can still be important with extensive soft tissue defects affecting form and function. We aimed to perform a comprehensive review and provide the current evidenced-based management to treat this condition.

Methods: A review was conducted to identify relevant published articles involving Fournier's gangrene in PubMed on September 8, 2021. Search keywords included "{[(Fournier's gangrene) AND (reconstruction)] OR [Fournier's gangrene]} AND [(repair) OR (management)]."

Results: A total of 108 articles met the inclusion criteria. The comorbidities most frequently associated included diabetes, hypertension, and obesity. Pillars of treatment involve urgent debridement, fluid resuscitation, IV antibiotics, and reconstruction. Several variables must be considered, including time to debridement, duration of antibiotics, debridement, and an individualized approach to choose a reconstructive option. Skin grafts and multiple types of flaps are commonly used for reconstruction.

Conclusions: Treatment of Fournier's gangrene should be initiated as early as possible. Surgeons' expertise, patient preference, and resources available are essential factors that should direct the election of reconstruction.

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Conflict of interest statement

Disclosure: Dr. Janis receives royalties from Thieme and Springer publishing. All the other authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
PRISMA flow diagram.
Fig. 2.
Fig. 2.
Extensive surgical debridement prevents progression of FG. The figure shows patient A with FG who underwent aggressive debridement and local dressing changes until granulation was noticed.
Fig. 3.
Fig. 3.
Meshed split-thickness skin grafting following FG debridement in patient A.
Fig. 4.
Fig. 4.
Preservation of the tunica vaginalis is critical to ensure success of STSG.
Fig. 5.
Fig. 5.
Postsurgical debridement of nonviable tissue in patient B with FG.
Fig. 6.
Fig. 6.
Perforated split-thickness skin grafting in patient B following initial debridement.
Fig. 7.
Fig. 7.
Evidence-based FG treatment flowchart.
See this image and copyright information in PMC

References

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