Experience in management of Fournier's gangrene

• Published in: Techniques in coloproctology Vol. 6; no. 1; pp. 5 - 13
• Main Authors: Villanueva-Sáenz, E, Martínez Hernández-Magro, P, Valdés Ovalle, M, Montes Vega, J, Alvarez-Tostado F, J F
• Format: Journal Article
• Language: English
• Published: Italy Springer Nature B.V 01.04.2002
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Colostomy; Combined Modality Therapy; Drug Therapy, Combination; Fournier Gangrene - microbiology; Fournier Gangrene - surgery; Fournier Gangrene - therapy; Genital Diseases, Male - microbiology; Genital Diseases, Male - surgery; Genital Diseases, Male - therapy; Humans; Male; Middle Aged; Treatment Outcome
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s101510200001

We report our experience and results in the management of Fournier's gangrene. Fournier's gangrene is a synergistic infective necrotizing fasciitis, which involves perianal, perineal and genital regions, originated mostly from colorectal and genitourinary sources. Charts and records from 28 patients with Fournier's gangrene diagnosed between 1993 and 1997 were reviewed. The mean patients age was 57.8 years (range, 22-82 years); mean hospital stay was 19 days. Eighteen patients (64.3%) were diabetic. The most common source of gangrene was ischiorectal abscess in 22 patients (78.6%). Colostomy was performed on 14 patients (50%) and cystostomy on 7 patients (25%). Ten patients (35.7%) died because of sepsis. In conclusion, medical and surgical treatment should be aggressive. Colostomy should only be performed if sphincter complex is damaged. Multidisciplinary management is mandatory, because of high morbidity and mortality.