Abstract:
OBJECTIVE:To examine the outcome of 23 consecutive patients with Fournier's gangrene. PATIENTS AND METHODS:Patients' charts were reviewed retrospectively from all those treated for Fournier's gangrene between July 1994 and July 1997 at the UCLA affiliated hospitals. RESULTS:Twenty-three patients were identified (mean age 51.7 years, range 13-71). The aetiologies included perirectal abscess (43%), urethral stricture (30%), scrotal abscess (21%) and unknown (4%). Predisposing factors included diabetes mellitus (43%), steroids or chemotherapy (21%), alcohol abuse (43%), malignancy (26%) and radiation therapy (9%). All 23 patients initially received wide debridement and placement of a percutaneous suprapubic tube. At the time of the first surgery, total scrotectomy was required in all, colostomy in 17% and penectomy in 4%. An additional 35% required eventual colostomy and an additional 9% required a penectomy. Patients underwent repeat debridement a mean of 2.5 times; the overall survival was 96%. CONCLUSION:Survival can be improved in patients with Fournier's gangrene by combining aggressive surgical and medical management. The keys to successful outcome included a high index of suspicion, prompt fluid resuscitation, rapid initiation of broad-spectrum antibiotics, a multidisciplinary approach, early surgical intervention with radical debridement, haemodynamic support in an intensive care setting, and frequent repeat operative debridement.
journal_name
BJU Intjournal_title
BJU internationalauthors
Corman JM,Moody JA,Aronson WJdoi
10.1046/j.1464-410x.1999.00140.xkeywords:
subject
Has Abstractpub_date
1999-07-01 00:00:00pages
85-8issue
1eissn
1464-4096issn
1464-410Xpii
bju140journal_volume
84pub_type
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