title: Fournier's Gangrene: A Summary of 10 Years of Clinical Experience.
abstract: We aimed to present our clinical experience with FG treatment. Fournier's gangrene (FG) is a rare but serious disease characterized by progressive necrosis in the genitourinary and perineal region. The retrospective study included 43 patients. Patients were divided into 2 groups as survivors and nonsurvivors. Included in the analysis were data pertaining to demographics, predisposing factors, comorbidities, results of bacteriologic analyses, number of debridements, duration of treatment, FG Severity Index (FGSI) score, fecal diversion methods (trephine ostomy or Flexi-Seal Fecal Management System-FMS), and dressing methods (wet or negative aspiration system). In the nonsurvivor group, urea, WBC, and age were significantly higher, whereas albumin, hematocrit, platelet count, and length of hospital stay (LOHS) were significantly lower compared to the survivor group. Mean FGSI was lower in survivors in comparison with nonsurvivors (5.00 ± 1.86 and 10.00 ± 1.27, respectively; P < 0.001). We conclude that FGSI is an important predictor in the prognosis of FG. Vacuum-assisted closure (VAC) should be performed in compliant patients in order to enhance patient comfort by reducing pain and the number of dressings. Fecal diversion should be performed as needed, preferably by using FMS. The trephine ostomy should be the method of choice in cases where an ostomy is necessary.
authors: 1 Department of General Surgery, Dicle University Medical Faculty, Diyarbakır, Turkey.
authors: Abdullah
authors: A
authors: Oguz
authors: Metehan
authors: M
authors: Gümüş
authors: Ahmet
authors: A
authors: Turkoglu
authors: Zübeyir
authors: Z
authors: Bozdağ
authors: Burak Veli
authors: BV
authors: Ülger
authors: Elif
authors: E
authors: Agaçayak
authors: Abdullah
authors: A
authors: Böyük
mesh_terms: D015897:Comorbidity; D003646:Debridement; D005260:Female; D018934:Fournier Gangrene / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D014421:Turkey
keywords: Fournier's gangrene; Mortality; Trephine ostomy; Vacuum-assisted closure