Evaluation of Fournier's necrosis in a high complexity hospital.
OBJECTIVE
To determine clinical characteristics of the population with Fournier's necrosis at Hospital Universitario del Valle (HUV) in Cali during the period 2003-2008.


METHODS
We performed a retrospective review of patients with the diagnosis of Fournier's necrosis at HUV during the period 2003-2008. We collected information on age,personal history, duration of illness, hospitalization, surgeries performed, time to surgical treatment, isolated germs, and mortality. Univariate descriptive analysis was performed in STATA v 10.1.


RESULTS
42 patients with mean age 51 years and 12 days mean disease duration. 26% had diabetes mellitus and 21.4% urethral trauma before admission. Average time to surgical debridement was 41.4 hours. 62% required suprapubic cystostomy, 14.3% derivative colostomy, 9.5% and 2.4% orchiectomy and penectomy respectively. The average hospital stay was 23 days and 12% required ICU care. Scrotal cultures were positive in 59.5%: 64% a single germ and 36% polymicrobial. Reported mortality was 17%.


CONCLUSIONS
Fournier's necrosis is a life-threatening clinical entity in patients with multiple comorbidities requiring multiple interventions. Broad-spectrum antimicrobial therapy, aggressive debridement of necrotic tissue and comprehensive management of these patients are the mainstays in the treatment of these severely ill patients.
Urology Department, Universidad del Valle, Cali, Colombia.
Andrés Humberto
AH
Vargas
Jorge
J
Carbonell
Daniel
D
Osorio
Herney Andrés
HA
García
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003125:Colostomy; D003422:Critical Care; D003559:Cystostomy; D003646:Debridement; D018450:Disease Progression; D018934:Fournier Gangrene / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D010413:Penis / Q000601:surgery; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013521:Urologic Surgical Procedures, Male; D055815:Young Adult
D000900:Anti-Bacterial Agents