Epidemiological Characteristics of Fournier’s Gangrene: A Report of 71 Patients

Abstract

Introduction: To identify the predisposing factors, etiological and clinical characteristics as well as the Fournier’s gangrene (FG) severity index (FGSI) in the outcomes of patients with FG. Materials and Methods: The data from 71 patients diagnosed with FG in a period of 17 years were retrospectively reviewed for the age of the patient, their history, predisposing factors, etiology, prodromal symptoms, FGSI, culture results, hospitalization period, surgical interventions, responses to the therapy and complications. Results: All of the patients were Caucasian males, and the mean age was 61.3 (range 36–92) years. The mean duration from the onset of symptoms to surgery was 7.5 days. The mean hospitalization time was 27.4 days and the most common etiological factor for FG was a perineal abscess. The overall mortality rate was 29.6%. The relationship between the number of predisposing factors and mortality rates in patients with FG was the most statistically significant parameter (p = 0.001). Conclusions: Multiple predisposing factors predict a poor prognosis and correlate significantly with mortality. Extension of the disease and the FGSI score were not predictive of outcome. The most essential intervention for stopping the rapidly progressing infectious process of FG consists of early recognition of the disease, proper management of the predisposing factors and aggressive surgical debridement. Such an intervention can improve clinical outcomes.

Fournier's Gangrene: Review of 120 Patients and Predictors of Mortality

“…Median debridement count was three (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Majority of the debridements were performed under spinoepidural anesthesia; however, twenty-seven patients (22.5%) required general anesthesia.…”

“…[1,[16][17][18] A study including 379 patients identified from a nationwide database has suggested that early surgical treatment within two days after admission reduces mortality of FG. [17] Also, the interval time between the onset of symptoms and initial debridement has been reported to be a major predictor of mortality.…”

“…There are several studies showing DM as a risk factor for patients with FG. [1,3,6,7] Nevertheless, there are also some studies where DM has been reported as one of the most frequent comorbidities in patients with FG although not influencing outcomes. [8][9][10][11]16,19] Although it was the most common co-morbidity among all patients, DM was not determined as a risk factor for mortality (p=0.429).…”

“…[1][2][3] These infections are typically polymicrobial, with both aerobic and anaerobic organisms present in the majority of cases. [3,4] In spite of the widely varying microorganisms in the etiology, its treatment is unique for all cases including emergency removal of the devitalized tissues, adequate resuscitation, and intravenous (iv) administration of wide-spectrum antibiotics.…”

“…[3,4] In spite of the widely varying microorganisms in the etiology, its treatment is unique for all cases including emergency removal of the devitalized tissues, adequate resuscitation, and intravenous (iv) administration of wide-spectrum antibiotics. [1][2][3][4][5][6][7] spectively maintained departmental FG database. Only adult patients admitted or referred to our department and diagnosed with FG were included in the study.…”