Favorable Outcomes With Early Component Separation, Primary Closure of Necrotizing Soft Tissue Infections of the Genitalia (Fournier's Gangrene) Debridement Wound Defects

Sandberg, Joanne C.; Warner, Hayden L.; Flynn, Kevin J.; Sexton, Shawn; Pham, Hanh; Kandler, Blaize W; Polgreen, Philip M.; Erickson, Beth

doi:10.1016/j.urology.2022.03.042

Cited by 7 publications

(2 citation statements)

References 18 publications

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“…Although the component separation primary wound closure after debridement was demonstrated to be safe, large defects or severe infections often need to be reconstructed. 122 Based on the location, size and depth of defects and the availability of local tissues, surgical reconstruction methods can be divided into skin grafts, local advancement flaps, scrotal flaps, multiple fasciocutaneous and myocutaneous flaps, and testicular transposition. 123 Meanwhile, for the reconstruction of defect larger than half of the scrotum area, systematic review recommended split-thickness skin grafting (STSG) or flaps.…”

Section: Postoperative Skin Reconstructionmentioning

confidence: 99%

Progress in Multidisciplinary Treatment of Fournier’s Gangrene

Zhang¹,

Shi²,

Chen³

et al. 2022

IDR

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Fournier's gangrene (FG) is a life-threatening and special form of necrotizing fasciitis, characterized by occult onset, rapid progress and high mortality, occurring mainly in men over 50 years of age. Risk factors of FG include diabetes, HIV infection, chronic alcoholism and other immunosuppressive state. FG was previously considered as an idiopathic disease, but in fact, three quarters of the infections originated from the skin, urethra and gastrointestinal tract. Initial symptoms of FG are often inconsistent with severity and can progress promptly to fatal infection. Although the treatment measures of FG have been improved in recent years, the mortality does not seem to have decreased significantly and remains at 20% -30%. The time to identify FG and the waiting period before surgical debridement are directly related to the prognosis. Therefore, in addition to the combination of intensive fluid resuscitation and broad-spectrum antibiotics, treatment of FG should particularly emphasize the importance of early surgical debridement assisted with fecal diversion and skin reconstruction when necessary. This paper is to briefly summarize the progress in the definition, epidemiology, clinical manifestations, diagnosis, treatment and prognosis of Fournier's gangrene in recent years, more importantly, illustrates the importance of multidisciplinary cooperation in the management of FG.

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Section: Postoperative Skin Reconstructionmentioning

confidence: 99%

Progress in Multidisciplinary Treatment of Fournier’s Gangrene

Zhang¹,

Shi²,

Chen³

et al. 2022

IDR

View full text Add to dashboard Cite

show abstract

“…10 Sandberg et al recently described early component separation and primary closure as a strategy to decrease convalescence time and wound care burden in FG. 11 This technique, which utilizes wide tissue mobilization above the underlying deep fascia lateral to the wound edges, may be more generalizable in the future alongside concurrent adoption of SSDe.…”

mentioning

confidence: 99%