title: Necrotizing Fasciitis of the Perineum and the Abdominal Wall-Surgical Approach.
abstract: Necrotizing fasciitis is a synergistic aerobical-anaerobical infection that rapidly spreads from its origin leading to foudroyant increasing soft tissue gangrene and systemic sepsis. In the perineal, perianal and genital regions it is referred to as Fournier's gangrene constituting a clinical entity with the gangrene of the abdominal wall. After a short presentation of the own experience with 17 patients the surgical approach to the life-threatening disease is presented reviewing the former and the recent literature. There is a worldwide consensus that immediate radical excision of the gangrene should be accompanied by intensive care measures. Functional and cosmetic defects are to be reconstructed in a second stage. However, morbidity and mortality remain high in spite of consequent treatment due to often associated significant co-morbidity of affected patients.
authors.affiliation: Surgical Department, MediClin Müritz-Klinikum GmbH, Waren, Müritz, Germany. karl-wilhelm.ecker@mueritz-klinikum.de.|Surgical Department, MediClin Müritz-Klinikum GmbH, Weinbergstraße 19, 17192, Waren, Müritz, Germany. karl-wilhelm.ecker@mueritz-klinikum.de.
authors.forename: Karl-Wilhelm
authors.initials: KW
authors.lastname: Ecker
authors.affiliation: Urological Department, MediClin Müritz-Klinikum GmbH, Waren, Müritz, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Baars
authors.affiliation: Surgical Department, MediClin Müritz-Klinikum GmbH, Waren, Müritz, Germany.
authors.forename: John
authors.initials: J
authors.lastname: Töpfer
authors.affiliation: Departments of Trauma, Hand, and Reconstructive Surgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Frank
keywords: Intensive care; Necrotizing fasciitis; Plastic reconstruction; Radical surgical excision; Soft tissue gangrene; Synergistic bacterial infection