Hyperbaric oxygen therapy adjunctive to surgical debridement in management of Fournier's gangrene: Usefulness of a severity index score in predicting disease gravity and patient survival

Janane, A.; Hajji, F.; Ismail, T. Ould; Chafiqui, J.; Ghadouane, M.; Ameur, A.; Abbar, M.; Albouzidi, A.

doi:10.1016/j.acuroe.2011.01.007

Cited by 27 publications

(29 citation statements)

References 18 publications

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“…Although many studies have reported the extent of disease to be a significant parameter between survivors and nonsurvivors, 21,22,[30][31][32][33]39 others have not found this parameter significant. 17,28 Extent of surgical debridement was categorized as being peno-scrotal only, extending down to lower limbs or extending up to the abdomen.…”

Section: Extent Of Diseasementioning

confidence: 98%

Fournier’s gangrene: A retrospective analysis of 26 cases in a Canadian hospital and literature

McCormack¹,

Valiquette²,

Ismail³

2015

CUAJ

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We performed a systematic review of all cases of Fournier's Gangrene (FG) at our hospital over a 12-year period. A total of 26 cases were assessed. Our goal was to determine the mortality rate and to identify risk factors associated with FG. We also wanted to examine three potential prognostic factors in relation to patient survival, including the time delay from emergency room admission to surgery, the initial extent of the disease, and the impact of more than one debridement procedure under general anesthesia. The time between emergency room admission and the beginning of surgical debridement was not statistically different between survivors and non-survivors. The extent of surgical debridement was close to the margin of statistical significance (p = 0.07) and can be considered an index of the extent of the disease. FG extending to the thighs or to the abdominal wall carries a worse prognosis. The number of surgical debridement procedures done under anesthesia was statistically different between survivors and nonsurvivors. Patients were 4.8 times more at risk of dying if they are required to have more than one surgical debridement under general anesthesia. This presumably reflects persistent gangrene following initial surgical debridement, fluid resuscitation, and wide spectrum antibiotic treatment.

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Section: Extent Of Diseasementioning

confidence: 98%

Fournier’s gangrene: A retrospective analysis of 26 cases in a Canadian hospital and literature

McCormack¹,

Valiquette²,

Ismail³

2015

CUAJ

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“…Additionally, the volume of necrosis appears to be a prognostic factor as some studies show patients with a gangrenous area less than 3% of the body surface rarely die, whereas patients presenting with a gangrenous area of 5% body surface area or more have a worse prognosis [Dahm et al 2000;Horta et al 2009;Janane et al 2011]. However, the association between larger gangrenous areas and worse prognosis is not universally accepted [Clayton et al 1990;Laor et al 1995].…”

Section: Investigationsmentioning

confidence: 99%

Contemporary diagnosis and management of Fournier’s gangrene

Chennamsetty

Khourdaji

Burks

et al. 2015

Therapeutic Advances in Urology

131

178

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“…[5] Hyperbaric oxygen treatment can be useful for the treatment of FG. [13] Early partial penectomy usually decreases morbidity in patients with gangrenous necrosis of glans penis. Chiang et al [14] performed partial penectomy to five dry gangrenous necrosis cases.…”

Section: Discussionmentioning

confidence: 99%

“…[5] Empirical broad spectrum antibiotics are given as first choice and can be changed according to the isolated bacteria. [13] Patients without diffuse penile and urethral involvement usually don't need suprapubic catheterization and urethral catheter is usually enough. [7] Patients seldom need penis amputation and orchidectomy is indicated.…”

Section: Discussionmentioning

confidence: 99%

Partial penectomy after debridement of a Fournier's Gangrene progressing with an isolated penile necrosis

Akbulut

Küçüktopçu

Sönmezay

et al. 2014

Ulus Travma Acil Cerrahi Derg

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Fournier's gangrene (FG) is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic and immune compromised patients. Here, we report an unusual case of FG with isolated glans penis necrosis in a diabetic 77-year-old male patient presented to the emergency department complaining 5 days of pain and darkening of the glans penis. Examination of the patient's glans penis was consistent with FG and included significant erythema and infectious discharge. He was given intravenous antibiotics and emergency debridement was done. On following days, the necrotic area spread to distal parts of both cavernosal areas. Partial penectomy was performed. Isolated penile involvement in FG is very rare. Performing partial penectomy in appropriate cases can save penile length, stop the progression of disease, and increase the quality of life.

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Hyperbaric oxygen therapy adjunctive to surgical debridement in management of Fournier's gangrene: Usefulness of a severity index score in predicting disease gravity and patient survival

Cited by 27 publications

References 18 publications

Fournier’s gangrene: A retrospective analysis of 26 cases in a Canadian hospital and literature

Fournier’s gangrene: A retrospective analysis of 26 cases in a Canadian hospital and literature

Contemporary diagnosis and management of Fournier’s gangrene

Partial penectomy after debridement of a Fournier's Gangrene progressing with an isolated penile necrosis

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