title: Fournier's gangrene current approaches.
abstract: Fournier's gangrene is a rare but highly mortal infectious disease characterised by fulminant necrotising fasciitis involving the genital and perineal regions. The objective of this study is to analyse the demographics, clinical feature and treatment approaches as well as outcomes of Fournier's gangrene. Data were collected retrospectively from medical records and operative notes. Patient data were analysed by demographics, aetiological factors, clinical features, treatment approaches and outcomes. Twelve patients (five female and seven male) were enrolled in this study. The most common aetiology was perianal abscess (41·6%). Wound cultures showed a mixture of microorganisms in six (50%) patients. For faecal diversion, while colostomy was performed in six cases (50%), Flexi-Seal was used in two cases (16·6%). In four patients (33·4%), no faecal diversion was performed. Negative pressure wound therapy (NPWT) system was effective in the last four patients (33·4%). The mean hospitalisation period in patients who used NPWT was 18 days, while it was 20 days in the others. NPWT in Fournier's gangrene is a safe dressing method. It promotes granulation formation. Flexi-Seal faecal management is an alternative method to colostomy and provides protection from its associated complications. The combination of two devices (Flexi-Seal and NPWT) is an effective and comfortable method in the management of Fournier's gangrene in appropriate patients.
authors.affiliation: Department of General Surgery, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakale, Turkey. ozkanfomer@gmail.com.
authors.forename: Omer F
authors.initials: OF
authors.lastname: Ozkan
authors.affiliation: Department of General Surgery, Faculty of Medicine, Kafkas University, Kars, Turkey.
authors.forename: Neset
authors.initials: N
authors.lastname: Koksal
authors.affiliation: Department of General Surgery, Faculty of Medicine, Bilim University, Istanbul, Turkey.
authors.forename: Ediz
authors.initials: E
authors.lastname: Altinli
authors.affiliation: Department of General Surgery, Bagcılar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: Celik
authors.affiliation: Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Uzun
authors.affiliation: Department of General Surgery, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakale, Turkey.
authors.forename: Oztekin
authors.initials: O
authors.lastname: Cıkman
authors.affiliation: Department of Urology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Akbas
authors.affiliation: Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Ergun
authors.affiliation: Department of Anestesiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
authors.forename: Hasan A
authors.initials: HA
authors.lastname: Kiraz
authors.affiliation: Department of General Surgery, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakale, Turkey.
authors.forename: Muammer
authors.initials: M
authors.lastname: Karaayvaz
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000628:therapy*; D001458:Bandages; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D018934:Fournier Gangrene / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D010502:Perineum / Q000503:physiopathology*; D012189:Retrospective Studies; D014945:Wound Healing / Q000502:physiology
keywords: Flexi-Seal Faecal Management System; Fournier's gangrene; Negative pressure wound therapy