Fournier’s Gangrene Experience: Retrospective Analysis of Thirty-five Cases

Abstract

Objectives: The purpose of this study was to analyze the results of Fournier’s gangrene patients who were followed and treated in our clinic. Materials and Methods: In this study, 35 of Fournier’s gangrene patients who were treated between January 2019-October 2020 were analyzed retrospectively. The patients’ results, including age, sex, gangrene localization, mortality rates, comorbidities, laboratory results, and microbiological results, were analyzed. Results: Thirty-four of the patients were male and 1 of them was female. Their mean age was 59.8 years. The duration of hospitalization was 25 days (range between 3-72), only 6 of them required intensive care unit. 2 of them died in this period (mortality: 5.7%). Twenty-four of the patients (65.2%) had hypertension (HT), 22 of them (62.9%) had diabetes mellitus. The mean level of C-reactive protein was 203.3 mg/L. The most influenced parts of the body were the scrotum in 27 patients (77.1%), perianal in 7 patients (20%), and perineal in 1 patient (2.9%). When we looked at the microbiological aspects of the cases, there was polymicrobial flora and Eschericia coli was the leading agent with the rate of 31.9%. All of the patients were followed after making adequate surgical debridement and they all were given the required antibiotic treatment. Local wound care has been done regularly. The additional procedures were required in some patients, which were orchiectomy in 31.4%, colostomy in 22.9%, and reconstruction with skin flap in 28.6%. Conclusion: Fournier’s gangrene is an infectious process that progresses rapidly and can be fatal if not diagnosed and treated early. A multidisciplinary approach is essential in the treatment program.

Keywords

• Fournier’s Gangrene
• Management
• Treatment

Fournier Gangreni Deneyimimiz: Otuz Beş Olguluk Retrospektif Analiz

Abstract

Amaç: Çalışmamızda kliniğimizde Fournier gangreni tanısı ile takip ve tedavi edilen hastaların sonuçlarını incelemeyi ve literatüre sunmayı amaçladık. Gereç ve Yöntem: Kliniğimizde Ocak 2019-Mart 2021 tarihleri arasında tedavi görmüş olan 35 Fournier gangreni hastası retrospektif olarak incelendi. Hastaların yaş, cinsiyet, gangren lokalizasyonu, mortalite durumu, ek hastalıkları, laboratuvar değerleri, mikrobiyolojik sonuçları analiz edildi. Bulgular: Otuz beş hastanın 34’ü erkek 1’i kadın olmak üzere ortalama yaş 59,8 olarak saptandı. Hastaların ortalama hastanede kalış süreleri 25 gün olup (3-72), 6 hastanın (%20,7) yoğun bakım ihtiyacı oldu. Yalnızca 2 kişi hayatını kaybetti (%5,7). Hastaların 24’ünde hipertansiyon (HT) (%68,6), 22’sinde diabetes mellitus (%62,9) eşlik etmekteydi. Hastaların C-reaktif protein seviyeleri ortalama 203,3 mg/L olarak saptandı. Fournier gangrenin ağırlıklı olarak görüldüğü yerler ise 27 hastada skrotal (%77,1), 7 hastada perianal (%20), 1 hastada ise perineal (%2,9) bölgelerdi. Hastalar mikrobiyolojik açıdan incelendiğinde polimikrobiyal flora dikkati çekmiştir ve Eschericia coli en sık görülen etken olmuştur (%31,9). Hastaların tamamına cerrahi debridman yapıldı ve antibiyoterapileri düzenlenerek takip edildi. Hastalara düzenli olarak lokal yara bakımı uygulandı. Ek işlem gereken hastaların %31,4’üne orşiektomi yapılmış olup, %22,9’una kolostomi açıldı. Olguların %28,6’sında ise deri flebi ile rekonstrüksiyon yapıldı. Sonuç: Fournier gangreni, hızlı ilerleyen, erken tanı konulup tedavi edilmediğinde mortal seyredebilen enfeksiyöz bir süreçtir. Tedavi programında multidisipliner bir yaklaşım şarttır.

Keywords

• Fournier Gangreni
• Tanı
• Tedavi

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