title: Necrotizing soft tissue infections (NSTIs): literary review and description of a Fournier syndrome case.
abstract: A 62 y.o. male with tight fimosis, swelling, redness, pain on palpating and necrosis of the penis and scrotum was admitted in our clinic, (FGSI = 6) with periferic vasculopathy; and diabetes mellitus type II and he was in dialysis treatment before the hospitalization. The patient was HCV affected. In 24 hours he underwent radical surgical debridement with excision of all necrotic material from penis and scrotum up to the subdermal layer and tissue of doubtful viability for about 75% of the skin and circumcision. In third, fifth and seventh postoperative days he underwent to local infusion of autologous PLT growth factors. The patient was discharged in 9th postoperative day and FGSI was still 6; the skin and subdermal tissue was barely reskined, with low homogeneous granulation, edema was heavely reduced. In our case, deviation from homeostasis status at admission was the main worrying factor. We found that diabetes mellitus and renal dysfunction at admission was also important risk factor for FG. "E.Coli" was the most common organism isolated from patient wound cultures. The FGSI is an objective and easy to apply score method to quantify the metabolic status and can be used to evaluate therapeutic options and assess results.
authors: Adelmo
authors: A
authors: Gubitosi
authors: Giancarlo
authors: G
authors: Moccia
authors: Roberto
authors: R
authors: Ruggiero
authors: Giovanni
authors: G
authors: Docimo
authors: Fabrizio
authors: F
authors: Foroni
authors: Emanuela
authors: E
authors: Esposito
authors: Giuseppe
authors: G
authors: Villaccio
authors: Alessandro
authors: A
authors: Esposito
authors: Ettore
authors: E
authors: Agresti
authors: Massimo
authors: M
authors: Agresti
mesh_terms: D018934:Fournier Gangrene / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D018461:Soft Tissue Infections / Q000473:pathology / Q000601:surgery*