title: [Perineal gangrene: clinical and therapeutic features and prognostic analysis of 35 cases].
abstract: OBJECTIVE
  The objective of this retrospective study of 35 cases of perineal gangrene was to describe their clinical and therapeutic features and to analyze the prognostic factors of mortality.
  
  
  METHODS
  From 1997 to 2004, 35 cases (25 men and 10 women, mean age=50.3 years) with perineal gangrene were treated in the "A" surgical department of Charles Nicole Hospital (Tunisia) with a combination of intensive care, antibiotic therapy, extensive excision and drainage, repeated if necessary and colostomy.
  
  
  RESULTS
  The mortality rate was 17.1%. The mean duration of hospitalization was 15.3 (range: 2-64) days. One patient had anal incontinence as sequelae. The colostomy in two patients was closed at the 9(th) and the 13(th) month. Statistical analysis showed that the extent of cellulitis, presence of myonecrosis, occurrence of septic shock need for postoperative mechanical ventilation, and IGSII and FGSIS severity scores differed significantly between patients who survived and those who died.
  
  
  CONCLUSIONS
  Perineal gangrene is still a very severe disease. The initial anatomic lesions, the IGSII and FGSIS severity scores and postoperative complications are the main prognostic factors of mortality.
authors.affiliation: Service de chirurgie viscérale, CHI de Poissy, F-78303 Poissy Cedex, France. drslimjarboui@yahoo.fr <drslimjarboui@yahoo.fr>
authors.forename: Slim
authors.initials: S
authors.lastname: Jarboui
authors.forename: Hichem
authors.initials: H
authors.lastname: Jarraya
authors.forename: Sami
authors.initials: S
authors.lastname: Daldoul
authors.forename: Sofiène
authors.initials: S
authors.lastname: Sayari
authors.forename: Mounir Ben
authors.initials: MB
authors.lastname: Moussa
authors.forename: Mohamed Morched
authors.initials: MM
authors.lastname: Abdesselem
authors.forename: Abdeljelil
authors.initials: A
authors.lastname: Zaouche
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000150:complications; D003125:Colostomy; D004322:Drainage; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005734:Gangrene / Q000150:complications / Q000401:mortality / Q000628:therapy; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D009336:Necrosis / Q000150:complications; D010502:Perineum / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012772:Shock, Septic / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents