Vacuum-assisted closure for the treatment of Fournier's gangrene.

Abstract:

BACKGROUND:Fournier's gangrene (FG) is a very aggressive necrotizing fasciitis involving subcutaneous fat and skin of scrotal and perineal regions. Vacuum-assisted closure (VAC) is a well-known method used to treat complex wounds. The authors for the first time enhance a multimodal strategy to treat the FG using VAC, reducing the number of surgical debridements, allowing a one-step surgical reconstruction with locoregional fasciocutaneous flap. METHODS:Six patients with the diagnosis of FG were reviewed retrospectively at our institution. All patients were affected by very extensive FG. The FG Severity Index (FGSI) was used to evaluate the prognosis of the case at admission. Following the acute phase (24-48 h), VAC was used to achieve wound cleaning and prepare the area to a single-stage reconstruction with superomedial thigh flap. Hyperbaric oxygen therapy was also used before final reconstruction. RESULTS:The average FGSI was 10.5, ranging from 8 to 12. All patients survived and were completely healed at the mean follow-up time of 9 months (range 3-30 months). CONCLUSIONS:VAC therapy is effective to clean and prepare the wounds, cutting off the fasciitis process and reducing the hospital stay and patient discomfort. Multidisciplinary treatment is mandatory during this devastating infection.

journal_name

Urol Int

journal_title

Urologia internationalis

authors

Cuccia G,Mucciardi G,Morgia G,Stagno d'Alcontres F,Galì A,Cotrufo S,Romeo M,Magno C

doi

10.1159/000218532

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

426-31

issue

4

eissn

0042-1138

issn

1423-0399

pii

000218532

journal_volume

82

pub_type

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