Relation between the area affected by Fournier's gangrene and the type of reconstructive surgery used. A study with 80 patients.
OBJECTIVE
To assess the affected skin area and the reconstructive techniques used in 80 patients affected by Fournier's gangrene.


METHODS
Eighty patients ranging in age from 19 to 85 years (mean = 51) affected by Fournier's gangrene were studied. When admitted to the emergency room the patients were submitted to clinical and laboratory examinations to analyze the gravity of the case. All patients were submitted to an extensive debridement of the lesion, urinary derivation by cystostomy and colostomy whenever necessary.


RESULTS
Only 13 patients (16.25%) died. From the 67 remaining patients, in 44 (65.6%) debridement was restricted to the scrotum, in 10 (14.9%) there has been scrotum and penile lesions and in 13 (19.3%) there has been a debridement of the scrotum and the perineal region. In 11 cases (16.4%) there was no need for reconstructive surgery with wound closing by second intention, in 16 cases (23.8%) reconstructive surgery was performed with mobilization of local skin, in 19 (28.3%) we have used skin grafts, 20 patients (29.8%) needed reconstructive surgery with the use of skin flaps and in 1 case (1.4%) there has been the use of skin flaps and grafts simultaneously.


CONCLUSIONS
Fournier's gangrene is a serious pathology and should be treated aggressively with an extensive debridement of the area with necrosis. The use of precocious reconstructive surgery of the genitals present good results and tends to greatly reduce the length of hospital stay and improve the psychological conditions of these patients.
Carvalho
Joao P
JP
Division of Urology, Souza Aguiar Municipal Hospital, Rio de Janeiro, RJ, Brazil.
Hazan
Andre
A
Cavalcanti
Andre G
AG
Favorito
Luciano A
LA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003646:Debridement; D018934:Fournier Gangrene / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010409:Penile Diseases / Q000473:pathology / Q000601:surgery; D010502:Perineum / Q000473:pathology / Q000601:surgery; D012611:Scrotum / Q000473:pathology* / Q000601:surgery*; D013524:Surgical Flaps; D014945:Wound Healing / Q000502:physiology