A prospective observational study of Fournier’s gangrene and its management
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 3198-3208
AbstractBackground: Fournier's gangrene is aec necrotizing fasciitis of the genitalia and perineum that can lead to polymicrobial infection and organ failure or death. The goal of this study was to identify the pre presence systemic and local predisposing factors, management challenges, and outcome in Telangana. Fournier gangrene is a urologic emergency that has a high mortality rate. It is a polymicrobial necrotizing fasciitis of the perineal, perianal, and genital regions with a mortality rate ranging from 15% to 50%.
Aims & Objectives: This study was undertaken to find out the age and sex incidence, etiological and risk factors, clinical features and outcome of patients, and evaluate the treatment options for Fournier’s gangrene.
Methods: It is a prospective observational study conducted in hospitals attached to Govt Medical College &Hospital, Siddipet in Department of General Surgery from June 2020 to May 2022. A total of 40 cases fulfilling the inclusion criteria were included in the study. Factors like age, gender, etiology, risk factors, clinical features, site of involvement, type of bacterial flora, reconstructive procedure used, duration of hospital stay and mortality were studied.
Results: A total of 40 patients were studied. 26 male and 4 female patients were in the study. Males are most afflicted (82.5%). M:F-4.7:1 In females, vulval induration, necrosis, perineal and perianal abscess were found. Scrotum (most common site) was afflicted in 26, perineum in 8, penis in 5, groyne in 3, and vulva in 2 patients. Six in research group suffered total scrotum loss. Only 2 patients came within 24 hours following RTA with degloving injuries to scrotum, penis and perineum. Most were approximately 1 week with a mean presentation of 6.8 days following disease onset. Those who came after 1 week experienced severe morbidity, late recovery, numerous debridements and prolonged hospital stays.
Conclusions: This study suggests that earlier presentation, early diagnosis and treatment with prompt debridement and appropriate antibiotics are the main stay of treatment. The resulting soft tissue defects following debridement required surgicall reconstruction, thus decreasing morbidity, hospital stay and early return of patients to regular life
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