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Review
. 2025 Jun 2;26(1):47.
doi: 10.1007/s11934-025-01275-3.

Modern Management of Fournier's Gangrene

Kyle J Kopechek  1 , Hiren V Patel  2 , George E Koch  2   3
Affiliations
Review

Modern Management of Fournier's Gangrene

Kyle J Kopechek et al. Curr Urol Rep. .

Abstract

Purpose of review: This review explores new evidence in Fournier's Gangrene management, emphasizing survivorship. We highlight the shift toward skin-sparing debridement techniques, new reconstructive strategies, and highlight limited evidence on outcomes. Additionally, we examine recent evidence on diagnosis, antimicrobial therapy, adjunctive treatments, and post-operative wound care.

Recent findings: New evidence supports the feasibility of skin-sparing debridement, reducing the need for extensive reconstruction while improving primary closure rates and lowering healthcare costs. Advances in reconstructive techniques accelerate wound healing and shorten hospital stays. Optimized wound management-integrating antimicrobial solutions, negative pressure therapy, and targeted antibiotics-continues to improve recovery while minimizing morbidity and mortality. Modern Fournier's management prioritizes early recognition, tissue preservation, and early genital reconstruction. Despite advancements, gaps remain in early diagnosis and long-term outcomes after the index admission. Further research on post-reconstruction recovery is essential to refine treatment protocols and determine quality of life for affected patients.

Keywords: Fournier’s gangrene; Genital reconstruction; Necrotizing soft tissue infection; Skin-sparing debridement; Wound care; Wound closure.

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Conflict of interest statement

Declarations. Disclosure and Human and Animal Rights Statements: This article does not contain any studies with human or animal subjects performedby any of the authors. Competing Interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Surgical Management of Fournier’s Gangrene via skin-sparing technique and primary reconstruction. (A) Initial presentation showing necrotic skin prior to debridement. (B) Limited debridement with small incisions performed at the outside hospital. (C) Subsequent debridement at tertiary center with extension of incisions to improve surgical exposure. (D) Vacuum-Assisted Closure therapy applied between debridement procedures. (E) Final wound closure post skin-sparing debridement. (F) Follow-up at one month
See this image and copyright information in PMC

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