The role of double-lumen irrigation-suction tube in the treatment of disseminated Fournier's gangrene: a single-center retrospective cohort study

Abstract

Background: The double-lumen irrigation-suction tube (DLIST) has demonstrated excellent efficacy in the treatment of complex infectious diseases; however, its application value in disseminated Fournier's gangrene (FG) remains undetermined. This research aims to assess the clinical efficacy and feasibility of DLIST in the treatment of disseminated FG.

Methods: A retrospective analysis was conducted on the clinical data of 34 patients with disseminated FG admitted from October 2012 to February 2025. The severity of the disease was evaluated using the Fournier's Gangrene Severity Index (FGSI) and the modified Uludag Fournier's Gangrene Severity Index (UFGSI). The patients were divided into the DLIST group (group A) and the conventional dressing change group (group B) according to whether the DLIST technique was used after debridement. Data from the two groups were compared and analyzed.

Results: Sixteen patients were treated with DLIST irrigation and suction, and 18 patients were treated with conventional dressing changes. No statistically significant differences were observed in FGSI and UFGSI scores between the two groups (P=0.49 and P=0.28, respectively). Compared with the conventional group, the DLIST group had significantly shorter wound closure time, lower daily gauze change frequency, reduced analgesic use frequency, and lower visual analogue scale scores (P=0.02, P<0.001, P<0.001, and P=0.02, respectively). The length of hospital stay (LOS) was also significantly shorter in the DLIST group (P=0.02). No deaths occurred in either group during the observation period.

Conclusions: The application of DLIST after debridement significantly shortens wound closure time and LOS in patients with disseminated FG, while reducing dressing change frequency and alleviating pain. However, these results require further validation through large-scale, prospective, randomized controlled trials.

Keywords: Fournier’s gangrene (FG); disseminated; double-lumen irrigation-suction tube (DLIST).

Figure 1

Flowchart of patient enrollment and outcome evaluation metrics. ^†, primary outcome; *, secondary outcomes. DLIST, double-lumen irrigation-suction tube; FG, Fournier’s gangrene; LOS, length of hospital stay; VAS, visual analogue scale.

Figure 2

Intraoperative placement of a DLIST in the debrided perineal wound of a patient with disseminated FG, demonstrating continuous saline irrigation and drainage. DLIST, dual-lumen irrigation-suction system; FG, Fournier’s gangrene.