Fournier’s gangrene: Causes, presentation and survival of sixty-five patients

Abstract

Objective:To report our experience with Fournier’s Gangrene (FG) over the past eight years and evaluate the predisposing factors which affect the mortality.Methods:Sixty-five patients who were admitted to emergency surgical unit of our institution presenting with FG between January 2006 and August 2014 were included. The anatomical site of infective gangrene, predisposing factors, etiological factors, and outcomes were retrospectively reviewed.Results:Our cases included 8 women and 57 men. The average age of men was 51±13.9 (range 19-75) and the average age of women was 63±10.5 (range 52-76). Average hospitalization time was 9.2±6.6 days (range 5-25) days. The most frequent comorbid disease was diabetes mellitus and the most frequent etiology was perianal abscess. Colostomy was performed in 11 patients, orchidectomy in two patients, cystostomy in two patients. Notably, all of the 8 (12.3%) patients who died from FG had diabetes and low socioeconomic status. A total of six patients who died required more than one surgical debridement.Conclusions:Fournier’s gangrene is a severe surgical emergency, with a high mortality rate. Low socioeconomic status, diabetes and more than one debridement play a major role in mortality and morbidity.

Fournier’s Gangrene: Five Years’ Experience from a Single Center in Turkey

“…Fournier's gangrene is known to be a rapid onset disease, but studies have shown that application to the hospital is delayed by an average of one week after initial symptoms have presented. [13] In our study, the median time from symptom onset to hospital application was four (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) days. Immediate diagnosis and treatment of FG are known to affect prognosis.…”

“…The age of the patients hospitalized in the intensive care unit (ICU) was found to be higher than the patients who did not require ICU admittance (65.33±11.63 years vs. 54.39±11.79 years, respectively; p=0.013). Median FGSI score was 2 (0-14), while the median UFGSI score was 4 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Median FGSI and UFGSI scores were found to be higher in patients accepted to the ICU compared to those who were not (4 vs. 2, p=0.025; and 6 vs. 3, p=0.002, respectively).…”

“…Early diagnosis is crucial for successful treatment and a favorable prognosis. [7] Radiological techniques (e.g., ultrasonography, computed tomography, and magnetic resonance imaging) aid physicians in the assessment of the condition, while physical examination and anamnesis are crucial for the diagnosis of FG. [8][9][10][11] The most common symptoms of FG include scrotal pain, swelling and erythema.…”

Fournier’s Gangrene: Literature Review and Clinical Cases

“…The cause of Fournier gangrene was polymicrobial association, with Proteus Mirabilis being the most predominant bacterium. Taken et al [5] described the case of 65 patients with Fournier gangrene in 8 years of follow-up. The authors also note that the most frequent concomitant pathology was diabetes mellitus; the cause of the development of swelling was a perianal abscess.…”

Fournier's gangrene: diagnosis and management aided by repeated clinical examination and ultrasound

“…Risk factors associated with Fournier's gangrene include immunosuppressive disorders, increasing age, obesity and diabetes 6 7. Our patient suffered with obesity, non-insulin-dependent diabetes, hypertension, hypercholesterolaemia and with the history of an infective source in the scrotum, hence the possibility of the development of a Fournier's gangrene could not be ignored.…”