Fournier gangrene is necrotic, life-threatening fasciitis occurring in the perineal region and within external sexual organs and anus. It may extend to the abdominal cavity, leading to soft tissue necrosis and sepsis. The article presents current methods of diagnosis and treatment of necrotising fasciitis (Fournier gangrene being a part of this disease) based on the medical literature and experience of two urological wards. The following methods are discussed: isotonic salt and balanced crystalloid fluids, antibiotics, steroids, immunoglobulin, hyperbaric oxygen therapy, surgical debridement and split-thickness mesh grafting. At the beginning broad spectrum antibiotics were administrated for the patients, according with local guidelines therapeutic committee and results of specimens for Gram’s staining and culture and laboratory tests. After receiving antibiogram prompt antibiotic treatment was continued. Cystostomy was done for everyone. Active dressing was applied rarely. Mortality was not observed in this group of patients. Fournier gangrene frequently ends with death due to sepsis, ARDS, or insufficiency of the kidneys, liver or other organs. Early diagnosis, careful debridement and application of a proper antibiotic are the basic factors that reduce mortality and improve treatment outcomes.

The aim of our study was to evaluate of short-term outcomes of 4210 patients underwent open abdominal open surgery with used either single absorbable or continuous layer sutures. Anastomosis were made by seromuscolar layer without mucosa. Fluid therapy: GDT and zero-balance GDT was also discussed. Anastomosis leakage developed in 6 patients. They were treated by creating the stomia. Septic shoc was treated in the same time. Re-anastomosis were made in delayed time. Re-anastomosis was performer after septic shoc treatment. Results of treatment with use of two-layer sutures, which was used before 1978. Analysis of 536 patients treated in the same time, in this group 53 patients developed anastomosis leakage. In this group 2 patients survived. The mode of anastomosis in the literature review was discussed. Attention was payed on advantage one-layer sutures under multi-layer sutures: Effectivness, simplicity and lower cost of treatment. Mechanical ileus was rarely observed since ceasing peritonisation abdominal cavity and softening after-operative course with patients with preoperative prepered intestinal track. Post-operetive complications were discussed. TC and MRI were the main tests of diagnosis of post-operetive complications. The main attention was focused on medical observation and clinical examination by experienced surger In order to serach post-operative complications. Antybiotic treatment in post-operation complications was presented and fluid therapy: GDT, zero-balance GDT and medical treatment of complication, such as: anastomosis leakage, mechanical ileus, inter-peritoneal abscess. Anastomotic stenosis was not observed in this group of patients.

Introduction. Fournier’s gangrene is a necrotising soft-tissue infection characterized by insidious and rapid onset. It belongs to the group of necrotising soft-tissue infections. The disease is more common in patients with systemic predispositions such as diabetes mellitus, obesity, hepatic cirrhosis, cancer, etc. Aim. The results of medical treatment thirtieths patients (man from 34 to 84 years old, middle age 67 years old) and co-morbidity with Fournier’s gangrene was presented. Material and methods. The co-morbidity was discussed and analized. The patients were treated by antishock therapy, proper antibiotic therapy was applied. The complications were presented during treatment, procedures with wounds, debridement and wounds treatment and final treatment skin deficiency. All patients had covered skin deficiency by mesh grafts, they were discharged from hospital with healed wounds or almost healed. Treatment from medical literature dealing with treatment and experience of Urological Wards was also presented (Fournier’s gangrene is a part of this disease). Results. Mortality was not observed in this group of patients. Conclusions. Fournier’s gangrene is a rapid-onset, life-threatening, acute urological disease requiring immediate diagnosis, as well as anti-shock and antibacterial therapy combined with intensive surgical debridement followed by the management of skin and soft tissue defects.