title: Enterostomy can decrease the mortality of patients with Fournier gangrene.
abstract: OBJECTIVE
  To determine the significance of enterostomy in the emergency management of Fournier gangrene.
  
  
  METHODS
  The clinical data of 51 patients (49 men and 2 women) with Fournier gangrene who were treated at our hospital over the past 12 years were retrospectively analyzed. The patients were divided into two groups according the surgical technique performed: enterostomy combined with debridement (the enterostomy group, n = 28) or debridement alone (the control group, n = 23). Patients in the enterostomy group received thorough debridement during surgery and adequate local drainage after surgery, as well as administration of broad-spectrum antibiotics. The clinical data and outcomes in both groups were analyzed.
  
  
  RESULTS
  The surgical procedures were successful in both patient groups. In the enterostomy group, 10 (35.8%) patients required skin grafting with a total of six debridement procedures. While in the control group, six (26.1%) patients required four debridement procedures. However, this difference was not statistically significant. Following surgery, the time to normal body temperature (6 d vs 8 d, P < 0.05) and average length of hospital stay (14.3 ± 7.8 d vs 20.1 ± 8.9 d, P < 0.05) were shorter in the enterostomy group. The case fatality rate was lower in the enterostomy group than that in the control group (3.6% vs 21.7%, P < 0.05).
  
  
  CONCLUSIONS
  Enterostomy can decrease the case fatality rate of patients with Fournier gangrene.
authors: Yan-Dong Li, Jian-Jiang Lin, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors: Yan-Dong
authors: YD
authors: Li
authors: Yan-Dong Li, Jian-Jiang Lin, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors: Wei-Fang
authors: WF
authors: Zhu
authors: Yan-Dong Li, Jian-Jiang Lin, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors: Jian-Jun
authors: JJ
authors: Qiao
authors: Yan-Dong Li, Jian-Jiang Lin, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors: Jian-Jiang
authors: JJ
authors: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001833:Body Temperature Regulation; D002681:China; D003646:Debridement; D004322:Drainage; D004630:Emergencies; D004766:Enterostomy / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D018934:Fournier Gangrene / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Enterostomy; Fournier gangrene; Infection; Necrotizing fasciitis; Surgery