Vacuum-assisted closure for the treatment of Fournier's gangrene.
BACKGROUND
Fournier's gangrene (FG) is a very aggressive necrotizing fasciitis involving subcutaneous fat and skin of scrotal and perineal regions. Vacuum-assisted closure (VAC) is a well-known method used to treat complex wounds. The authors for the first time enhance a multimodal strategy to treat the FG using VAC, reducing the number of surgical debridements, allowing a one-step surgical reconstruction with locoregional fasciocutaneous flap.


METHODS
Six patients with the diagnosis of FG were reviewed retrospectively at our institution. All patients were affected by very extensive FG. The FG Severity Index (FGSI) was used to evaluate the prognosis of the case at admission. Following the acute phase (24-48 h), VAC was used to achieve wound cleaning and prepare the area to a single-stage reconstruction with superomedial thigh flap. Hyperbaric oxygen therapy was also used before final reconstruction.


RESULTS
The average FGSI was 10.5, ranging from 8 to 12. All patients survived and were completely healed at the mean follow-up time of 9 months (range 3-30 months).


CONCLUSIONS
VAC therapy is effective to clean and prepare the wounds, cutting off the fasciitis process and reducing the hospital stay and patient discomfort. Multidisciplinary treatment is mandatory during this devastating infection.
Cuccia
Giuseppe
G
Department of Urology, Messina University, Messina, Italy.
Mucciardi
Giuseppe
G
Morgia
Giuseppe
G
Stagno d'Alcontres
Francesco
F
Galì
Alessandro
A
Cotrufo
Stefano
S
Romeo
Marco
M
Magno
Carlo
C
D000368:Aged; D018934:Fournier Gangrene / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D012189:Retrospective Studies