Experience in management of Fournier's gangrene.
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.
Villanueva-Sáenz
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E
Colon and Rectum Surgery Department, Dr. Bernardo Sepúlveda Specialty Hospital, National Medical Center of the 21st Century, Mexican Institute for Social Security, Mexico City, Mexico. edvilla@netservice.com.mx
Martínez Hernández-Magro
P
P
Valdés Ovalle
M
M
Montes Vega
J
J
Alvarez-Tostado F
J F
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003125:Colostomy; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D018934:Fournier Gangrene / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D005832:Genital Diseases, Male / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents