Rare causes of acute purulent-inflammatory lesions of pararectal tissue and Fournier's gangrene

Nikolsky, V.I.; Sergatsky, K I; Ogorodnik, E V

doi:10.17116/hirurgia202002168

Khir. Z. im. N.I. Pirogova

2020

DOI: 10.17116/hirurgia202002168

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Rare causes of acute purulent-inflammatory lesions of pararectal tissue and Fournier's gangrene

V.I. Nikolsky

K I Sergatsky

E V Ogorodnik

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Cited by 3 publications

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“…Nevertheless, successful treatment of these patients has been previously reported [11-14].Reports of Fournier gangrene in women are rare [15], and there are no data in obstetric practice. Pregnancy itself, particularly its pathological course, contributes to the development of immunodeficiency [16,17]. Surgical interventions on the perineum (i.e., episiotomies, vaginal tissues, and perineum restoration after traumatic childbirth); surgical delivery, including cesarean section; and damage to nearby organs, specifically the urethra, bladder, and rectum, all contribute to the parturient occurrence of this disease.…”

mentioning

confidence: 99%

Fournier gangrene in puerperas after cesarean section

Ryzhkov¹,

Gasparyan²,

Derevyanko³

et al. 2021

Medical news of the North Caucasus

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клинический случай clinical case F ournier gangrene (epifascial necrosis) is a specific form of necrotizing fasciitis that affects patients of both sexes and of any age. However, it is mainly observed in men suffering from immunodeficiency [1, 2], especially in those with injuries of the genitals and perineum. Cases of the development of Fournier gangrene after piercing and injection of drugs into the veins of the penis and cavernous bodies have been described [3, 4]. Streptococcus, Staphylococcus, Escherichia coli, and microbial associations involving anaerobic bacteria play a significant role as infectious agents [5-7]. The disease is characterized by the vastness and high rate of lesion spread; total necrosis can develop up to the anterior abdominal wall and even further into the axillary areas as well as the inner surface of the thighs. This is owing to the mixed nature of the infection, involving the release of enzymes and toxins by microbes; this causes high pathogenic-ity and thrombosis in the vessels, resulting in tissue necrosis. Owing to tissue hypoxia, anaerobes that produce hyaluronidase, lecithinase, and collagenase begin to actively multiply. These favorable conditions aid the microorganisms in rapidly overcoming interstitial and fascial barriers [8, 9]. The mortality rate is extremely high and can exceed 40 % [10]. Nevertheless, successful treatment of these patients has been previously reported [11-14].Reports of Fournier gangrene in women are rare [15], and there are no data in obstetric practice. Pregnancy itself, particularly its pathological course, contributes to the development of immunodeficiency [16,17]. Surgical interventions on the perineum (i.e., episiotomies, vaginal tissues, and perineum restoration after traumatic childbirth); surgical delivery, including cesarean section; and damage to nearby organs, specifically the urethra, bladder, and rectum, all contribute to the parturient occurrence of this disease.

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mentioning

confidence: 99%

Fournier gangrene in puerperas after cesarean section

Ryzhkov¹,

Gasparyan²,

Derevyanko³

et al. 2021

Medical news of the North Caucasus

View full text Add to dashboard Cite

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Septic complications after abdominal delivery (literature review)

Galkina,

Makarenko,

Ulyanova

2024

Rus. J. Hum. Repro.

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Practical application of the wound healing agent in the treatment of patients with acute paraproctitis

Lichman,

Katorkin,

Andreev

et al. 2024

Ambulatornaya khirurgiya

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Introduction. Acute paraproctitis is an acute inflammation of the peri-rectal tissue, caused by the spread of the inflammatory process from the anal crypts and anal glands. One of the typical complications of treatment of all forms of acute paraproctitis is relapse of the disease. An extensive literature is devoted to this issue; it is this problem that encourages surgeons to persistently search for more rational methods of treatment. The rate of these complications ranged from 9.9% to 50%. Postoperative wound healing after opening paraproctitis is protracted, in some cases requiring repeated surgical interventions. The use of modern antiseptic solutions and dressings in the intraoperative and postoperative periods should improve the immediate results of treatment.Aim. To study the effectiveness of the use of the wound healing agent Chitokol-KDA in the treatment of patients with acute paraproctitis.Materials and methods. A prospective comparative randomized study was conducted in the department of coloproctology and the specialized advisory center of the Clinics of Samara State Medical University in 2024. The study included 105 patients who underwent autopsy of acute purulent paraproctitis in an inpatient setting. In the main group (n = 51), the wound healing agent Chitokol-KDA was used as an addition to treatment. In the control group (n = 54), no additional means were used during dressing.Results and discussion. From the data obtained on the use of the wound-healing agent Chitokol-KDA, it follows that it reduces the intensity of the pain syndrome by the 3 days, and also accelerates the healing time and epithelialization of wounds (t = 2.17, p = 0.032), but does not affect the timing of the appearance of granulations (t = 0.88, p = 0.38).Conclusion. The use of the wound-healing agent Chitokol-KDA reduces pain in the postoperative period, accelerates wound healing and does not affect the incidence of perirectal fistulas.

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Rare causes of acute purulent-inflammatory lesions of pararectal tissue and Fournier's gangrene

Cited by 3 publications

References 15 publications

Fournier gangrene in puerperas after cesarean section

Fournier gangrene in puerperas after cesarean section

Septic complications after abdominal delivery (literature review)

Practical application of the wound healing agent in the treatment of patients with acute paraproctitis

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