Fournier's gangrene in a single-center experience: a retrospective analysis of 23 cases
Abstract
Purpose: This study aims to retrospectively evaluate the outcomes of patients diagnosed with Fournier’s gangrene (FG) treated and followed up in our clinic and to contribute to the literature.
Materials and methods: We retrospectively analyzed the data of 23 patients diagnosed with Fournier's gangrene and treated in our clinic between October 2015 and October 2024. Parameters such as age, gender, localization of gangrene, mortality status, comorbidities, laboratory findings, treatment methods, and microbiological results were evaluated.
Results: Of the 23 patients, 18 (78.3%) were male, and 5 (21.7%) were female, with a mean age of 56.1 years (range: 26-78). The average time from symptom onset to hospital presentation was 7.95±4.67 days. The average hospital stay was 16.2 days (range: 2-35), and 11 (47%) patients required intensive care. Mortality occurred in 4 (17.4%) patients. Comorbidities were present in 17 (74%) patients, while 6 (26%) had no comorbid conditions. Hypertension (HT) and diabetes mellitus (DM) were the most common comorbidities, each seen in 9 (52.9%) patients. The mean C-reactive protein (CRP) level was 203.3 mg/L. Gangrene was predominantly observed in the perianal region in 9 (39.13%) patients, the perineal region in 8 (34.79%) patients, and the scrotal region in 3 (13.04%) patients. Microbiological analysis revealed polymicrobial flora, with Escherichia coli being the most common pathogen (30.4%). All patients underwent surgical debridement and were treated with appropriate antibiotic therapy and regular wound care. Colostomy was performed in 14 (60.8%) patients, while vacuum-assisted closure (VAC) therapy was applied to 6 (26.8%).
Conclusion: Fournier's gangrene is a rapidly progressing and potentially fatal infectious disease if not diagnosed and treated promptly. A multidisciplinary approach is essential to achieving successful outcomes in its management.
Keywords
Fournier's Gangrene, colostomy, VAC
Supporting Institution
yok
Ethical Statement
the Local Ethics Committee of Pamukkale University Faculty of Medicine (ethics approval number: E-60116787-020-650169).
References
- Norton KS, Johnson LW, Perry T, Perry KH, Sehon JK, Zibari GB. Management of Fournier’s gangrene: an eleven year retrospec tive analysis of early recognition, diagnosis, and treatment. Am Surg. 2002;68:709-713.
- Chernyadyev SA, Ufimtseva MA, Vishnevskaya IF, et al. Fournier’s Gangrene: Literature Review and Clinical Cases. Urol Int. 2018;101(1):91-97. doi:10.1159/000490108
- Singh A, Ahmed K, Aydin A, Khan MS, Dasgupta P. Fournier's gangrene. A clinical review. Arch Ital Urol Androl. 2016;88(3):157-164. doi:10.4081/aiua.2016.3.157
- Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg. 2000;87(6):718-728. doi:10.1046/j.1365-2168.2000.01497.x
- Mallikarjuna MN, Vijayakumar A, Patil VS, Shivswamy BS. Fournier's Gangrene: Current Practices. ISRN Surg. 2012;2012(1):942437. doi:10.5402/2012/942437
- Prohorov AV. Furnier’s gangrene. Kazan Med J. 2016;97(2):256 261. doi:10.17750/KMJ2016-256
- Montrief T, Long B, Koyfman A, Auerbach J. Fournier Gangrene: A Review for Emergency Clinicians. J Emerg Med. 2019;57(4):488-500. doi:10.1016/j.jemermed.2019.06.023
- Aridogan AI, Izol V, Abat D, Karsli O, Bayazit Y, Satar N. Epidemiological characteristics of Fournier’s gangrene: a report of 71 patients. Urol Int. 2012;89(4);457-461. doi:10.1159/000342407
- Martinschek A, Evers B, Lampl L, Gerngroß H, Schmidt R, Sparwasser C. Prognostic aspects, survival rate, and predisposing risk factors in patients with Fournier's gangrene and necrotizing soft tissue infections: evaluation of clinical outcome of 55 patients. Urol Int. 2012;89(2):173-179. doi:10.1159/000339161
- Sökmen S. Fournier gangreni. Ankem Derg. 2012;26(Ek 2):331-336.
