Factors Affecting Outcome in Patients of Fournier’s Gangrene- A Study
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 8
Abstract
Introduction: Fournier’s gangrene is a rapidly progressive necrotising fasciitis of genitalia, perineum and abdominal wall, that primary involves subcutaneous tissue up to deep fascia. It is a vascular gangrene of infective origin. It is polymicrobial, synergistic infection caused by aerobic and anaerobic organism from colorectal, genitourinary or cutaneous infection. It has got high mortality rate and multiple factors on patient and treatment part affect outcome. Material and Method: 74 patients with diagnosis of Fournier’s gangrene admitted from September 2014 to September2015 and also which were admitted in last 10yearsin our facility were studied by records. The variables studied were age, haemoglobin, haematocrit, TLC, duration between start of illness and presentation, random blood sugar, comorbidity, serumsodium, potassium, bicarbonate, creatinine, blood urea, pulse and respiratory rate, BP with h/o hypertension, area involved, fever. Blood transfusion, pusculture, antibiotics given. All patients underwent extensive debridement and empirically antibiotics covering gram positive gram negative and anaerobes used subsequently changed after culture sensitivity. Demographic, Disease and Treatment related data is collected and analysed. Variables were compared in survivor and non-survivor group by using statistical methods. Result & Conclusion: The most commonly affected were 40 and 70 years aged males. Disease affecting in early age was found more aggressive and extensive. Prognosis was found poor in patients presented with age > 45 years, lower mean haemoglobin and haematocrit, mean TLC value>15000/cumm, uncontrolled diabetes, high blood urea and creatinine, electrolyte imbalance. Ecoli was found to be most common organism. Elective use of more than one antibiotic covering whole spectrum of aerobic and anaerobic organism gives good outcome. The overall mortality came out to be 5.4%. Result indicates that aggressive management in these patients improves outcome.
Authors and Affiliations
Dr A Silodia
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