Fournier's gangrene described in 1883 by Jean Alfred Fournier, still poses ethiopathogenic, evolutive and therapeutic problems. This is a therapeutic emergency; early diagnosis, medical and surgical treatments contribute to reducing mortality rate. Tissue defect engendered by infection and/or by its excision requires morphological and functional reconstruction. The choice of the reconstruction technique depends on several parameters: early or delayed coverage, the size of the defect, the local capital skin and the patient's general condition. Through this study involving 95 cases of scrotal and perineal gangrene treated at the National Center of Burns and Plastic Surgery of Ibn Rochd University Hospital of Casablanca over a period of 10 years (2004-2014), we report our approach in the surgical management of defect secondary to Fournier's gangrene.

Introduction: The bacterial nosocomial infection remains a common cause of death in patients who have sustained a severe burn injury. Material and Methods: We conducted a prospective study of 45 patients hospitalized in the ICU burns Hospital IBN-ROCHD of Casablanca over a period of six months, from 1 January 2014 to 30 June 2014. The criteria for nosocomial infection were those of the Center for Disease Control in Atlanta in 1988. Result: Incidence rates were calculated. The bacterial ecology of the service was described as also antibiotype. The population was predominantly male (14 women and 31 men). Their average age was 39 years; the occurrence of 17 nosocomial infections in 45 patients appeared from this study. The cumulative incidence was 103 infections per 1000 days of treatment. Regarding the characteristics of bacterial infections, infected sites were skin (69%), blood (18%), urinary tract (12%) and lungs (1%). The main organisms were: Staphylococcus sp. (37.7%), Pseudomonas aeruginosa (19.8%), Enterococcus faecalis and Proteus mirabilis (18.5%). Staphylococci were méthicillin-resistant in 22% of cases. Pseudomonas and Acinetobacter were multi-resistant (66%). The establishment of the bacterial ecology of the service helped us set the right rules of prescription of antibiotics. Conclusion: Finally, controlling the epidemic risk posed by the emergence of resistant organisms is necessary to combine the practice of good antibiotic therapy and prevention.

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