Prognostic factors in Fournier gangrene

Ruíz-Tóvar, Jaime; Córdoba, Lea Paloma; Devesa, J. M.

doi:10.1016/j.asjsur.2012.04.006

Cited by 59 publications

(59 citation statements)

References 11 publications

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“…In our study, the mean duration of symptoms was 5 days (0-21) days, which is longer than the periods described in other studies. 6 However, we did not find any statistically significant difference between our two groups. Determining whether surgical debridement is necessary in FG is mostly based on the surgical team's opinion after wound examination.…”

Section: Discussioncontrasting

confidence: 48%

“…Although recent technological improvements in antimicrobial agents has increased the spectrum and efficacy of these drugs, early surgical intervention remains the principal therapy for FG because tissue necrosis can rapidly progress (up to 2 cm/h) and sepsis leading to death quickly can develop. 6,7 Many underlying conditions contribute to the formation of FG, such as diabetes mellitus, immunosuppression, local trauma, genitourinary infections, acquired immunodeficiency and malignancy. All of these conditions lead to a decline in the host immunity and contribute to polymicrobial infection.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier’s Gangrene

Anuk¹,

Yıldırım²,

Güzel³

et al. 2017

TJCD

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Amaç: Fournier gangreni (FG) anorektal bölgenin klinik olarak çok hızlı kötüleşen, ölümcül nekrotizan fasiitidir. FG tedavisinin temelini agresif cerrahi debridman oluşturur. Güncel skorlama sistemleri FG'de mortalite üzerine yoğunlaşmıştır. Bununla birlikte serum belirteçleri yararlı olabilir. Bu çalışmada FG hastalarındaki debridman sayısını belirlemede monosit-lenfosit oranının (MLO) klinik etkisini ortaya koymayı amaçladık. Yöntem: 2010-2016 yılları arasında hastanelerimiz acil servisinde FG tanısıyla tanı konup opere edilen 59 hasta çalışmaya dahil edildi. Tek debridman uygulanan grup 1 ve birden çok debridman uygulanan hastalar grup 2 olarak iki gruba ayrıldılar. Grupların ortalama yaş, cinsiyet, semptom süresi, predispozan faktör, yara kültür pozitifliği, kolostomi durumu, yatış anındaki MLO'lar, tedavi protokolleri, mortalite oranları karşılaştırıldı. Bulgular: İki grup arasında yara kültür sonuçları ve kolostomi durumları arasında istatistiksel anlamlı fark bulundu (p=0,001 ve p=0,008). Mortalite oranları arasında anlamlı fark bulunamadı (p=0,749). Predispozan faktörler ve semptomların süresi arasında gruplar arası anlamlı fark bulunamadı (p=0,069, p=0,091). Grup 2'de MLO anlamlı oranda yüksekti (p<0,001). 0,549 cut-off değerinde MLO debridman sayını öngörmede %79,4 sensitivite ve %76 oranında spesifiteye sahipti. Ayrıca MLO debridman sayısını diğer faktörlerden bağımsız olarak öngörebilmekteydi (p<0,001). Sonuç: MLO değeri birden çok debridman yapılan hastalarda anlamlı oranda yüksek bulundu. Bu sonuç, MLO'nun tek bir parametre olarak FG ciddiyetini göstermesi bakımından önemlidir. Gelecekte düzenlenebilecek daha yüksek hasta popülasyonlu çalışmalar parametrenin gücünü gösterebilmeleri açısından önem kazanmıştır. Anahtar Kelimeler: Fournier gangreni, debridman, monosit, lenfosit ÖZ ABSTRACTAim: Fournier's gangrene (FG) is a rapidly progressive, fulminant necrotizing fasciitis of the anogenital region. Treatment of FG consists of aggressive surgical debridements. The current scoring systems in FG focus on mortality. However, simple biomarkers could be useful. Here we aim to investigate the clinical usefulness of monocyte-to-lymphocyte ratio (MLR) in determining the number of debridements in FG patients. Method: Fifty-nine patients were diagnosed with FG and operated in the emergency unit between 2010 and 2016. The patients were separated into a single-debridement group and a multiple-debridement group. The groups were compared in terms of mean age, gender, duration of symptoms, predisposing factors, wound culture positivity, MLR values at admission, treatment protocols, and mortality rates. Results: The two groups differed significantly in wound culture results and colostomy status (p=0.001 and p=0.008). There was no significant difference in mortality rate (p=0.749). Furthermore, there were no significant differences between the groups in terms of predisposing factors or duration of symptoms (p=0.069 and p=0.091). The multiple-debridement group had a significantly higher MLR value (p<0.001). MLR under ...

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier’s Gangrene

Anuk¹,

Yıldırım²,

Güzel³

et al. 2017

TJCD

View full text Add to dashboard Cite

show abstract

“…Median debridement count was three (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Majority of the debridements were performed under spinoepidural anesthesia; however, twenty-seven patients (22.5%) required general anesthesia.…”

Section: Resultsmentioning

confidence: 99%

“…[1,3,6,7] Nevertheless, there are also some studies where DM has been reported as one of the most frequent comorbidities in patients with FG although not influencing outcomes. [8][9][10][11]16,19] Although it was the most common co-morbidity among all patients, DM was not determined as a risk factor for mortality (p=0.429).…”

Section: Discussionmentioning

confidence: 99%