Fournier's gangrene: a review of 38 cases in a tertiary hospital
Journal Title: International Journal of Medical Research and Review - Year 2016, Vol 4, Issue 9
Abstract
Background: Fournier’s gangrene is an infective necrotizing fasciitis of the perineal, genital or perianal regions. It is caused by polymicrobial infection. The infective process leads to thrombosis of subcutaneous blood vessels, resulting in gangrene of the overlying skin. It has high morbidity and mortality. Study design: Case series. Aim of the study: To study the incidence, age distribution, mode of presentation, abnormalities in biochemical parameters, to lay down parameters for prognostication and study the outcome of fournier's gangrene. Methodology: This prospective study was conducted upon 38 patients diagnosed with Fournier's gangrene in surgical unit of our institute from November 2007 – October 2009. Results: Total number of surgical admissions in our institution during the period from November 2007 – October 2009 were 11,507. Of which, the number of cases of Fournier’s Gangrene were 38 (Incidence - 0.33%). The highest incidence of Fournier’s gangrene is seen to occur in 4th and 5th decades. The main features at the time of presentation were scrotal pain, fever, scrotal edema and scrotal skin necrosis. Commonest source of infection is found to be genitourinary. The extensive lesions often tended to be of anorectal origin and in diabetic patients. E. coli was the commonest organism isolated followed by Klebsiella and Staphylococcus. Anaerobes were identified by gram stain. On an average in patients stay was around 16 days. Conclusion: Fournier's gangrene is associated with high mortality. Early recognition, aggressive debridement, broad-spectrum antibiotics and intensive supportive care helps in reduction of mortality.
Authors and Affiliations
Araboina Upender, Goparaju Shanti Kumar, Dodda Ramesh Kumar, Sheelam Kalavathi
Keywords
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