What are the indications for a stoma in Fournier's gangrene?
OBJECTIVE
This study examined the indications for a stoma in patients with Fournier's gangrene and its impact on outcome.


METHODS
Patients with Fournier's gangrene were retrospectively reviewed for indications for a stoma. Patients with and without a stoma were compared, based on demographics, disease severity, surgical therapy, length of hospital stay, clinical outcome and cost.


RESULTS
Forty-four patients (median age 57 years, range 28-77 years) were evaluated. Eighteen had a temporary stoma and 26 did not. A stoma was 5 times more likely in males. Patients with Fournier's gangrene originating from an anorectal disorder received a stoma more often than patients with disease originating from an urogenital disorder. Clinical outcomes were similar for patients with or without a stoma. Stoma closure was associated with an extra cost of about $6650 per patient.


CONCLUSIONS
Stoma creation in the management of Fournier's gangrene was needed for selected patients. Having a stoma did not appear to affect outcomes and resulted in a significant increase in cost of care.
Ozturk
E
E
Department of General Surgery, Uludag University Faculty of Medicine, Bursa, Turkey. drozturk@uludag.edu.tr
Sonmez
Y
Y
Yilmazlar
T
T
D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000150:complications*; D003422:Critical Care; D003646:Debridement; D004766:Enterostomy / Q000191:economics / Q000706:statistics & numerical data*; D005242:Fecal Incontinence / Q000150:complications; D005260:Female; D018934:Fournier Gangrene / Q000191:economics / Q000209:etiology* / Q000382:microbiology / Q000601:surgery*; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000150:complications*; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D014570:Urologic Diseases / Q000150:complications; D055815:Young Adult