New Approach to the Management of Fournier's Gangrene

Abstract

A new method of treating Fournier's gangrene is described in 13 patients. There was no mortality and the average hospital stay was 10 days. Considerable gain in man-hours and expense was recorded when compared with the old method of treatment with antibiotics and wound debridement.

The density and distribution of endothelin 1 and endothelin receptor subtypes in normal and diabetic rat corpus cavernosum

“…Hyperglycaemia ( > 20 mM) per se, through the production of advanced glycosylation end products, has also been shown to inhibit EDW/NO directly, as well as inducing changes in endothelium dependent relaxation through the production of endothelin-1, vasoconstrictive prostanoids and oxygen-free radicals [13,14]. Topouzis et aI.…”

“…Data from two recent series lend support to the lesser importance of the classical aggressive surgical approach to survival. Attah [14] treated 1 3 patients with parenteral broad spectrum antibiotics and wound dressings for approximately 2 days followed by scrota1 amputation and primary closure. All patients in this series survived: nearly 70% were discharged within 10 days and healed primarily: only four wounds became infected or separated.…”

Fournier’s gangrene in a modern surgical setting: improved survival with aggressive management

“…Since 1883, when Jean Alfred Fournier first described what was then thought to be an idiopathic gangrene of the scrotum [ 4], the prognosis has been ominous. Mortality rates have been high despite the institution of a broad range of treatment protocols [ 5–9]. Over the past 3 years, the survival rate of our patients with Fournier’s gangrene has been high.…”

Fournier’s Gangrene: Risk Assessment and Enzymatic Debridement with Lyophilized Collagenase Application

“…Triple broad-spectrum antibiotics, effective against both aerobic and anaerobic microorganisms, should immediately be administered parenterally, prior to debridement in all cases [2, 3, 28, 29]. All necrotic tissue and that with doubtful viability should be debrided and excised.…”