title: Vacuum-assisted closure for the treatment of Fournier's gangrene.
abstract: 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.
authors.affiliation: Department of Urology, Messina University, Messina, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cuccia
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mucciardi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
authors.forename: Francesco
authors.initials: F
authors.lastname: Stagno d'Alcontres
authors.forename: Alessandro
authors.initials: A
authors.lastname: Galì
authors.forename: Stefano
authors.initials: S
authors.lastname: Cotrufo
authors.forename: Marco
authors.initials: M
authors.lastname: Romeo
authors.forename: Carlo
authors.initials: C
authors.lastname: Magno
mesh_terms: D000368:Aged; D018934:Fournier Gangrene / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D012189:Retrospective Studies