title: [Perineal-scrotal gangrene: epidemiological and therapeutic aspects. About 45 cases].
abstract: Perineoscrotal gangrene is an acute disease, a rare and severe affection of the perineum, whose evolution is unpredictable and rapidly extensive. The diagnosis is clinical. The paraclinical examinations allow early diagnosis and assessment of anatomical and biological repercussions. We conducted a retrospective study of 45 patients spread over six years, involving a multidisciplinary team consisting of three specialists (urologists, visceral, plastic surgeons). The average age was 52 years. The largely male dominated our series. Fournier gangrene was the most common etiology. We noted five cases of death (11%) in the acute phase, secondary to septic shock (four patients) or multiple organ failure (one patient). The evolution was favorable in 40 other patients in the series, requiring an initial management in intensive care unit, and surgical treatment. The average hospital stay was 17 days. After the acute phase, all patients underwent a surgery for skin coverage, ranging from guided healing (two patients) to musculocutaneous flap of the gracilis (six patients) via the secondary suture (four patients), the burying the testes (18 patients) and half thick skin graft, with a functional and aesthetic result was acceptable, and minimal sequelae. In our series, the most predictive prognostic factors would be the delay of care, sepsis on admission and associated diseases.
authors: Unité de chirurgie plastique, faculté de médecine et de pharmacie, université Cadi Ayyad, CHU Mohammed VI, Marrakech, Morocco.
authors: S
authors: S
authors: Ettalbi
authors: Y
authors: Y
authors: Benchamkha
authors: S
authors: S
authors: Boukind
authors: H
authors: H
authors: Droussi
authors: S
authors: S
authors: Ouahbi
authors: M
authors: M
authors: Soussou
authors: K
authors: K
authors: Elatiqi
authors: M A
authors: MA
authors: Lakmichi
authors: Z
authors: Z
authors: Dahami
authors: S M
authors: SM
authors: Moudouni
authors: I
authors: I
authors: Sarf
authors: K
authors: K
authors: Rabbani
authors: A
authors: A
authors: Louzi
authors: R
authors: R
authors: Benelkhaiat
authors: B
authors: B
authors: Finech
mesh_terms: D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D018934:Fournier Gangrene / Q000453:epidemiology* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D033183:Interdisciplinary Communication; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011300:Preoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology