Fournier's gangrene: a prospective study of 57 patients with special reference to validity of Fournier's gangrene severity index in predicting the outcome and mortality

Epidemiological study on Fournier syndrome in a tertiary hospital in Jundiaí-SP from October 2016 to October 2018†

“…In the present study, 78.26% of male patients were affected, data consistent with the literature. 3,7,8 The literature reports that the fifth decade of life is the average age of involvement; the present study found similar data, with a mean age of 55.6 years.…”

“…There is no prevalence of ethnicity in patients diagnosed with Fournier's syndrome in the literature. [1][2][3]7,9 The current studies of the disease are aimed at identifying predisposing factors for its development. Diabetes mellitus is the most common comorbidity associated with gangrene, present in 40-70% of patients; other comorbidities that may be associated include immunosuppression (HIV, presence of malignant neoplasms, corticosteroid therapy), neuropathies, renal and liver failure, hypertension, and obesity.…”

“…[3][4][5] Clinical course of infection and necrosis occurs through sudden pain in the perianal/perineal region with or without scrotal edema; it is commonly associated with purulent or secretion-producing wounds, signs of crackling and skin fluctuation, prostration, pallor, and fever above 38 • C. 5,6 Progression is rapid and begins with a cellulite adjacent to the infection's entry port, associated with macerated skin and fetid odor after deeper tissue involvement and progression of bacterial colonization; the wound presents with necrotic material drainage associated with deterioration of the general condition; finally, extensive necrosis of subcutaneous tissue generates sepsis, multiple organ failure, and death. 2,7,8 In addition to the symptoms already mentioned, the Fournier's gangrene diagnosis may be supported by laboratory and imaging tests. However, the laboratory pattern is nonspecific and without obvious findings, with anemia, leukocytosis, thrombocytopenia, electrolyte abnormalities, hyperglycemia, increased serum creatinine, azotemia, and hypoalbuminemia.…”

Pattern and outcome of management of Fournier's gangrene in a resource-constraint setting

“…The high mortality rate in FG has led to the use of different validated scoring systems as a means of predicting probable outcomes in these patients. [ 16 ] These scoring systems include the Laboratory Risk Indicator for Necrotizing Fascitis,[ 43 ] FGSI,[ 44 45 46 ] and its modifications, the UFGSI,[ 47 ] and the simplified FGSI. [ 48 49 50 ] The FGSI is based on physiologic and metabolic status of the patients and was first described in 1995.…”

“…In the present study, the patients that died had FGSI and UFGSI of 9.2 ± 3.7 and 12.5 ± 5.7, respectively, while the patients that survived had FGSI and UFGSI of 5.4 ± 3.3 and 3.2 ± 3.2, respectively, ( P = 0.04, 0.05) as reported by the previous studies. [ 45 46 51 ] Among the patients who absconded from the hospital during the period of admission, mean FGSI and UFGSI were 4.7 ± 0.9 and 8.0 ± 2.1. These patients did not die on admission but had absconded from admission due to prolonged hospital stay with the resultant economic cost in lost man hours and financial difficulties in an environment of near absence of viable health insurance.…”