Fournier’s gangrene and diabetes mellitus:Our experience with 50 patients
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 2
Abstract
Introduction: Fournier’s gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum. In this study we aimed to share our experience as association of diabetes mellitus as most important and independent risk factor for development of Fournier’s gangrene and its direct relation to mortality. Methods: This is a retrospective study of the patient admitted in RCSMGMC CPR Hospital from January 2015 to June 2016, of 50 patients with Fournier’s gangrene and diabetes mellitus to analyze association of diabetes mellitus for development of Fournier’s gangrene and as a prognostic indicator of mortality. Results: All the 50 patients were male. The mean age was 48 years (range 30– 75 years). Average length of treatment was 25.8 days (from 14 to 36 days). The most common predisposing factor was diabetes mellitus (100%). E. coli was the most frequent bacterial organisms cultured. Etiology of FG was perianal infection in 36 patients (72 %), Urogenital infection in 11 patients (22 %), and skin infection in 3 patients (6 %). All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide surgical excision. The mortality rate was 24%. The advanced age, renal failure on admission, extension of infection to the abdominal wall, occurrence of septic shock and need for postoperative mechanical ventilation are the main prognostic factors of mortality. Dm was not determined as a risk factor for mortality. Conclusions: Fournier’s gangrene is still a very severe disease with high mortality rates. Early recognition of infection associated with invasive and aggressive treatment is essential to reduce these prognostic indices. Our hypothesis is that the key of the successful treatment is to treat as soon as symptoms onset, early and aggressive necrosectomy under broad antibiotic coverage. Dm was not determined as a risk factor for mortality.
Authors and Affiliations
Shivprasad Hirugade, Harish N Patil, Shilpa S Hirugade
Keywords
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