title: Comparison of Diverting Colostomy and Bowel Management Catheter Applications in Fournier Gangrene Cases Requiring Fecal Diversion.
abstract: In some patients of Fournier gangrene originated from perianal region, it is important to prevent fecal contamination in order to provide healing without wound infection. For this purposes, diverting colostomy or bowel management catheter methods were performed. In this study, it is aimed to carry out a comparison of prognosis and cost efficiency between diverting colostomy and bowel management catheter methods applied for preventing fecal contamination in Fournier's gangrene patients. Fourty-eight patients with diagnosis of Fournier's gangrene, serious perianal infections, and preserved sphincters and without rectum injury after debridement were included in the study. The cases were divided into two groups as patients who were subjected to colostomy for fecal diversion and who were subjected to bowel management catheter without colostomy. Then, the groups were compared in terms of age, predisposing factors, duration of hospital stay, mortality, additional surgery requirements, and cost. Fourty-eight patients were included the study. Sixteen patients were treated without colostomy. Decreased duration of total hospital stay, additional surgery requirements, and hospital expense in bowel management catheter group has determined. It is thought that preferring bowel management catheter method instead of colostomy in patients without rectum injury, who require diverting colostomy and have undamaged anal sphincters, can relieve patients, patients' relatives, healthcare organizations, and the national economy of a serious burden. In addition, although patients' satisfaction and workforce loss factors are not taken into consideration in this study, the bowel management catheter method is thought to have positive effects also on these parameters.
authors.affiliation: Department of General Surgery, Cukurova University Medical Faculty, Saricam, Adana, Turkey.
authors.forename: Ismail Cem
authors.initials: IC
authors.lastname: Eray
authors.affiliation: Department of General Surgery, Cukurova University Medical Faculty, Saricam, Adana, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Alabaz
authors.affiliation: Department of General Surgery, Cukurova University Medical Faculty, Saricam, Adana, Turkey.
authors.forename: Atilgan Tolga
authors.initials: AT
authors.lastname: Akcam
authors.affiliation: Department of General Surgery, Cukurova University Medical Faculty, Saricam, Adana, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ulku
authors.affiliation: Department of General Surgery, Cukurova University Medical Faculty, Saricam, Adana, Turkey.
authors.forename: Cem Kaan
authors.initials: CK
authors.lastname: Parsak
authors.affiliation: Department of General Surgery, Cukurova University Medical Faculty, Saricam, Adana, Turkey.
authors.forename: Gurhan
authors.initials: G
authors.lastname: Sakman
authors.affiliation: Department of Biostatistics, Cukurova University Medical Faculty, 01260 Saricam, Adana, Turkey.
authors.forename: Gulsah
authors.initials: G
authors.lastname: Seydaoglu
keywords: Bowel management catheter; Colostomy; Necrotising infection