Rekonstruktive Möglichkeiten nach Fournier-Gangrän

Abstract

In the literature, various methods for reconstruction after Fournier gangrene are described. Reconstruction with a flap is required for a good functional result in complex regions as the scrotum and penis, while cutaneous wounds can be managed through skin grafting. Patient compliance and tissue demand are crucial factors in the decision-making process.

A contemporary case series of Fournier’s gangrene at a Swiss tertiary care center—can scoring systems accurately predict mortality and morbidity?

“…Fournier’s gangrene (FG) is a life-threatening infection of the genital, perineal, and perianal regions first described by Fournier in 1883 [ 1 ]. The male to female ratio is reported as 10:1 [ 2 ], with an incidence of 1:7500 to 1:750,000 [ 3 ]. Conditions leading to decreased host immunity and thus rapid spread of infection are considered predisposing factors [ 3 ].…”

“…The combination of aerobic and anaerobic bacteria can lead to the production of several enzymes, such as collagenases and heparinases, which may result in tissue destruction and rapid progression of the infection. Thus, the combination of less pathogenic bacteria can develop high virulence in immunocompromised patients [ 2 ]. The FG diagnosis is based on clinical and laboratory findings.…”

Son Bir Yıl İçindeki Nekrotizan Fasiitis Tanısı Alan Hastaların Değerlendirilmesi

“…Literatür ile uyumlu olarak hastaların nekrotizanfasiitis tanısı aldıktan sonra debritman için ortalama 3 kez ameliyata alındığı (min:2, max:6) görüldü. Agresif debritman sonrası ortaya çıkan defektin büyüklüğüne bağlı olarak primer kapama, flep çevirme teknikleri ve negatif basınçlı yara kapama yöntemleri uygulanabilir [12][13][14][15][16] .Bu çalışmada agresif nekroz debritmanı sonrası hastalıksız sağlam dokuya ulaşıldıktan sonra hastaların %69'una (n:9) negatif basınçlı kapama yöntemi uygulandığı, %31 hastaya ise (n:4) debritman sonrası ortaya çıkan defektleri onarmak için flep ile kapama uygulandığı görüldü.…”