[Gangrene of the perineum. Plea for a standardized therapeutic management apropos of 50 cases].
From 1988 to 1992, 50 cases of perineal gangrene were treated with a therapeutic protocol combining: a) repeated extensive excisions, b) hyperbaric oxygen therapy, even before surgery if this was possible, and c) intensive care. The mortality rate was 24% (12/50). It was even higher in patients admitted more than 6 hours after diagnosis. The average stay in hospital was of 20 (+/- 2) days. Four patients presented with residual signs. Twenty-eight (56%) had had colostomy for lesions originating in the rectum or threatening the anal margin; 9 of these patients died, while gastrointestinal continuity was restored in another 17 cases. There were three predictive factors of survival in this series: a) early diagnosis and treatment, b) severity index on admission, c) some associations of bacteria.
Hôpitaux Sud, Marseille.
C
C
Brunet
J R
JR
Delpero
G
G
Guerinel
A
A
Geissler
A
A
Barthélémy
J M
JM
Sainty
X
X
Thirion
R
R
Grégoire
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003125:Colostomy; D003646:Debridement; D005260:Female; D005734:Gangrene / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D010502:Perineum; D011237:Predictive Value of Tests; D015996:Survival Rate
Gangrènes du périnée. Plaidoyer pour une conduite thérapeutique standardisée à propos de 50 observations.