title: Fournier's gangrene: is it scrotal gangrene?
abstract: BACKGROUND
  Fournier's gangrene was originally described as scrotal gangrene in young males. Today, it is generally accepted as synergistic necrotizing fasciitis of perineal, genital, or perianal regions, and the epidemiologic data have changed. However, there are still limited data about females due to the lack of female patients, even in large case series.
  
  
  METHODS
  A retrospective review of the medical records of all patients who received surgery for emergency conditions over the past 22 years was performed to identify patients with Fournier's gangrene. Data from these patients were then reviewed to determine the age, gender, etiology, causative bacteria, predisposing factors, treatment modalities, length of hospital stay, and morbidity and mortality rates associated with Fournier's gangrene. Data were evaluated using multivariate analyses.
  
  
  RESULTS
  Sixty-five patients (20 female) were identified with the diagnosis of Fournier's gangrene. The mean age was 50.8 years. The most common etiology was hemorrhoidectomy in male and perianal abscess in female patients. The most commonly isolated microorganism in both male and female patients was Escherichia coli. Twenty-nine patients had diabetes mellitus, which was the most common predisposing factor. Mean hospitalization time was 24.4 days and the overall mortality was 27.70%.
  
  
  CONCLUSIONS
  Fournier's gangrene is still an important disease with high mortality rates in spite of the developments in intensive care units and new-generation antibiotics. It seems that there are no major differences between male and female patients in the characteristics of the condition.
authors.affiliation: Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Atil
authors.initials: A
authors.lastname: Cakmak
authors.forename: Volkan
authors.initials: V
authors.lastname: Genç
authors.forename: Cihangir
authors.initials: C
authors.lastname: Akyol
authors.forename: H Ayhan
authors.initials: HA
authors.lastname: Kayaoğlu
authors.forename: Selçuk M
authors.initials: SM
authors.lastname: Hazinedaroğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D004926:Escherichia coli; D005260:Female; D018934:Fournier Gangrene / Q000453:epidemiology* / Q000382:microbiology / Q000601:surgery; D006801:Humans; D007711:Klebsiella pneumoniae; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D012307:Risk Factors; D012611:Scrotum; D012737:Sex Factors; D013211:Staphylococcus aureus; D055815:Young Adult