title: [Fournier syndrome: evaluation and initial treatment].
abstract: The records of 48 patients with Fournier's syndrome (FS) treated at the Emergency Surgical Service of the Hospital das Clínicas of the University of São Paulo Medical School in the period 1982-1991 were reviewed. Clinical and laboratory data at admission were analysed. The following factors were statistically significant when associated with bad prognosis: elevated serum creatinine, hypoxemia, metabolic alkalosis or acidosis, diabetes and age over 50 years. Based on these five criteria, the patients were divided into two groups: Group I, mild FS (32 cases) and Group II, severe FS (16 patients). This classification permits a better planning of therapy. In cases classified as severe, treatment should include wide débridement, with resection of all necrotic tissues, scheduled reoperations for further débridements, transverse colostomy, wide spectrum antibiotic therapy and total parenteral nutrition. In the mild cases, the patients may be treated with débridement and antibiotics only.
authors.affiliation: Serviço de Cirurgia de Emergência do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.
authors.forename: E
authors.initials: E
authors.lastname: Steinman
authors.forename: E M
authors.initials: EM
authors.lastname: Utiyama
authors.forename: L F
authors.initials: LF
authors.lastname: Maximiniano
authors.forename: R G
authors.initials: RG
authors.lastname: Belivacqua
authors.forename: D
authors.initials: D
authors.lastname: Birolini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005734:Gangrene / Q000209:etiology / Q000473:pathology / Q000628:therapy; D005832:Genital Diseases, Male / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012611:Scrotum / Q000473:pathology*; D013577:Syndrome
vernacular_title: Síndrome de Fournier: avaliação e tratamento inicial.