Abstract:
OBJECTIVE:The prognosis of Fournier's gangrene (FG) depends on early diagnosis and management. In this study, our objective was to identify the distinct features of FG that may influence the clinical outcome. METHODS:A retrospective chart review was performed in patients with a diagnosis of FG between January 1999 and December 2003. Etiological and predisposing factors, causative microbiological organisms, and clinical outcome were investigated. RESULTS:Twenty-five men (71%) and 10 women (29%) were included in the study. Mean age was 59.7 +/- 10.7 (range: 43-88) years. As a predisposing factor, diabetes mellitus (DM) was found to be in 46% of patients. All patients were treated by immediate debridement and wide-spectrum antibiotics. More than one bacterium was found in 75% of the patients' tissue cultures, and most frequently E. coli (43%) was identified. Although there were no etiological factors in 25 patients (71%), various etiological factors were found in 10 patients (29%). Multiple debridements were performed in the majority of the cases. The overall mortality rate was 40%. The mortality rates were found to be relatively higher in patients with diabetes mellitus (DM; 50%), with delayed admission to the hospital (45%), and in patients presenting with sepsis at the first admission to the hospital (78%) compared with others. In the logistic regression model, the presence of sepsis was as the only significant independent risk factor for mortality in FG. CONCLUSIONS:Despite the use of contemporary effective antibiotic treatment, aggressive debridements, and state-of-the-art intensive care conditions, FG still has high mortality and morbidity rates. In our series mortality rates were found to be higher in patients with delayed admission to the hospital, those with DM, and those who initially presented with sepsis.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Yanar H,Taviloglu K,Ertekin C,Guloglu R,Zorba U,Cabioglu N,Baspinar Idoi
10.1007/s00268-005-0777-3subject
Has Abstractpub_date
2006-09-01 00:00:00pages
1750-4issue
9eissn
0364-2313issn
1432-2323journal_volume
30pub_type
杂志文章abstract:BACKGROUND:The World Health Organization Surgical Safety Checklist (SSC) has been widely implemented in an effort to decrease surgical adverse events. METHOD:This systematic literature review examined the effects of the SSC on postoperative outcomes. The review included 25 studies: two randomised controlled trials, 13...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-016-3519-9
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Patients with HIV/AIDS on antiretroviral therapy (ART) live longer and now require surgery for indications similar to those described for the general population. They have been previously reported to carry higher mortality and complication rates, especially septic complications. The aim of this study was to ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-2994-8
更新日期:2015-07-01 00:00:00
abstract::With the recent regulations limiting resident work hours, it has become more important to understand how residents spend their time. The volume and content of the pages they receive provide a valuable source of information that give insight into their workload and help identify inefficiencies in hospital communication...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0740-9
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Traditional perioperative care for colonic surgery in elderly patients is associated with increased morbidity and mortality compared to that of younger patients. Although multimodal perioperative rehabilitation has evolved as a valid concept to improve postoperative outcome, its use has not yet been establis...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-009-0018-2
更新日期:2009-08-01 00:00:00
abstract::Adenocarcinomas of the esophagogastric junction (AEG) are now recognized as a separate tumor entity with increasing incidence. The aim of the present study was to evaluate whether positron emission tomography (PET) using the glucose analog F-18-fluorodeoxyglucose (FDG) can be used for metabolic characterization of thi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7058-9
更新日期:2003-09-01 00:00:00
abstract::During the course of tumor progression the differentiated morphologic and functional characteristics of differentiated thyroid carcinomas (DTC) disappear. This corresponds to more aggressive growth, metastatic spread, and loss of iodine uptake. Experimental data give strong evidence that differentiated functions of io...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900436
更新日期:1998-06-01 00:00:00
abstract::Uncontrolled bleeding from the cystic artery and its branches is a serious problem that may increase the risk of intraoperative lesions to vital vascular and biliary structures. On laparoscopic visualization anatomic relations are seen differently than during conventional surgery, so proper knowledge of the hepatobili...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00012372
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Five billion people lack access to surgery. Accurate and complete data have been identified as essential to the global scale-up of perioperative care. This study retrospectively validates the Mbarara Surgical Services Quality Assurance Database (SQUAD), an electronic outcomes database at a Ugandan secondary ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05537-8
更新日期:2020-08-01 00:00:00
abstract::Node dissection for melanoma remains the most important therapeutic decision for the optimal management of the patient with melanoma. In Australia and in some parts of the United States, the majority of patients with intermediate thickness melanoma (1.6-4.00 mm) will undergo elective lymph node dissection. In Europe, ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Although mortality after liver resection has declined, posthepatectomy liver failure (PHLF) remains a major cause of operative mortality. To date there is not consensus on a definition for PHLF. However, there have been many efforts to define PHLF causing operative mortality. In the present study we sought t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-1959-z
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:The survival impact of distal pancreatectomy (DP) with celiac axis resection for locally advanced pancreatic body/tail cancer remains unclear. METHODS:A total of 16 patients underwent DP with celiac axis resection, while 76 underwent standard DP for pancreatic body/tail cancer. The indications for DP with c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3670-3
更新日期:2017-01-01 00:00:00
abstract::The goal of fluid resuscitation in the burn patient is maintenance of vital organ function at the least immediate or delayed physiological cost. To optimize fluid resuscitation in severely burned patients, the amount of fluid should be just enough to maintain vital organ function without producing iatrogenic pathologi...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02067109
更新日期:1992-01-01 00:00:00
abstract::Hepatectomy with vascular reconstruction for biliary malignancy remains controversial. This study aimed to clarify the indications for surgery. Patients with advanced hilar bile duct cancer (HBDC) (n = 26) and gallbladder cancer (GBC) involving the hepatoduodenal ligament (n = 13) who underwent hepatectomy were enroll...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6801-6
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Hepatic trisectionectomy is a challenge for surgeons. We describe a technique by combination of the Glisson pedicle method and anterior approach to perform hepatic trisectionectomy. METHODS:In this technique, the Glisson pedicles are isolated above the hilar plate without hilar dissection. After dividing th...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2579-y
更新日期:2014-09-01 00:00:00
abstract::In a double-blind placebo-controlled study we investigated the effect of recombinant human erythropoietin (r-HuEPO), on the perioperative hemoglobin concentration and the use of blood transfusions in patients undergoing elective colorectal surgery with a preoperative hemoglobin level =8.5 mmol/L. Altogether 100 were...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s002689900561
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:The Lancet Commission on Global Surgery showed that countries with surgeon, anesthetist, and obstetrician (SAO) densities of 20-40 SAO/100,000 population were associated with improved health outcomes and recommended a global surgical workforce scale-up by 2030. Whether countries would be able to achieve such...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05329-9
更新日期:2020-04-01 00:00:00
abstract::With limited resources and the current concerns about using animals for research purposes, the needs must be clear when setting up trauma and sepsis experiments for pharmacologic interventions. Such interventions are performed typically for four reasons: (1) to study the pathophysiologic role of certain mediators (whi...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900077
更新日期:1996-05-01 00:00:00
abstract:INTRODUCTION:The use of outcomes to evaluate surgical quality implies the need for detailed risk adjustment. The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a generally applicable risk adjustment model suitable for pancreatic surgery. A pancreaticoduodenectomy (...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2554-7
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:Sentinel lymph node biopsy (SLNB) is the standard of care for staging N0 primary early breast cancers (EBC). Patients in developing countries mostly present with large (LOBC) or locally advanced cancers (LABC) and are treated with neo-adjuvant chemotherapy (NACT). Accuracy of SLNB in staging stage III N0 a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3222-2
更新日期:2016-07-01 00:00:00
abstract::Met protein is a tyrosine kinase receptor for hepatocyte growth factor (HGF). c-Met has morphogenic, mitogenic, and motogenic properties and is overexpressed in many solid tumors. We studied c-met mRNA and protein expression in papillary thyroid carcinomas and nonneoplastic thyroid tissue. The c-met mRNA was detected ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680020167
更新日期:2001-05-01 00:00:00
abstract::Angiogenesis is of vital importance during the development and progression of solid tumors. Vascular endothelial growth factor (VEGF) is a major regulator of angiogenesis and could be produced by some cancer cells. To investigate the clinical relevance of VEGF in the tumorigenesis of human thyroid, an immunohistochemi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680020085
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Single-incision laparoscopic cholecystectomy (SILC) has been increasingly performed recently. Although it seems plausible that SILC will be associated with less pain compared to standard 4-port laparoscopic cholecystectomy (LC), there is currently no conclusive comparative study on the postoperative pain iss...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0842-4
更新日期:2011-02-01 00:00:00
abstract:INTRODUCTION:The role for diverting ostomy as a method to help reduce morbidity and mortality has been well established in the combat trauma population. However, factors that influence the type of ostomy used and which ostomies become permanent are poorly studied. We examine patterns of ostomy usage and reversal in a l...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4759-7
更新日期:2019-01-01 00:00:00
abstract:INTRODUCTION:Jejunal diverticula are rare lesions, and when complications arise, they pose diagnostic difficulties. Perforation is a common complication resulting in an acute abdomen, although preoperative diagnosis is usually not possible. The "gold standard" for management for patients with complications is surgery. ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9469-0
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:The goal of the present study was to determine the frequency, mode of presentation, and need for reoperation in the treatment of recurrent inguinal hernia at Liaquat University Hospital, Jamshoro, Sindh, Pakistan. METHODS:This descriptive, cross-sectional study was conducted over a period of four years, fro...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1897-1
更新日期:2013-03-01 00:00:00
abstract::Acute acalculous cholecystitis (AAC) is a well known complication in severely traumatized patients. Existing data of AAC originate from retrospective analyses and episodic case reports. In a prospective study 45 polytraumatized patients admitted to our intensive care unit from January 1989 to June 1990 were clinically...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067089
更新日期:1992-11-01 00:00:00
abstract::Endocrine surgeons have had an important role in the management of hyperthyroidism due to either Graves' disease or toxic nodule(s). Since alternative treatments such as antithyroid drugs or radioiodine are also available, the decision-making for management should be based on clear assessment of advantages and limitat...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680010167
更新日期:2000-08-01 00:00:00
abstract:INTRODUCTION:Accidental intraoperative gallbladder perforation is a problem in laparoscopic surgery, especially in cases with incidental gallbladder carcinoma (IGBC). The question is whether intraoperative gallbladder perforation has a prognostic disadvantage or a retrieval bag provides protection against tumor dissemi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0163-7
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:It has been reported that the paraesophagogastric devascularization with esophageal transection procedure, also known as the modified Sugiura procedure, was effective in the treatment of variceal bleeding. However, it was not widely accepted by other surgeons because of the high rate of rebleeding, complicat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2478-2
更新日期:2014-08-01 00:00:00
abstract::The effect of a treatment versus controls may be expressed in relative or absolute terms. For rational decision-making, absolute measures are more meaningful. The number needed to treat, the reciprocal of the absolute risk reduction, is a powerful estimate of the effect of a treatment. It is particularly useful becaus...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7916-8
更新日期:2005-05-01 00:00:00