Retalho fasciocutâneo de região interna de coxa para reconstrução escrotal na síndrome de Fournier

Mauro, Victor

doi:10.1590/s1983-51752011000400030

Cited by 7 publications

(11 citation statements)

References 4 publications

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“…A polymicrobial flora is usually found, including gram-ne gative bacteria (e.g., Escherichia coli, Proteus mi rabilis, Klebsiella sp., Pseudomonas, Bacteroides sp., Aci netobac ter sp. ), gram-positive bacteria (e.g., staphylococci, streptococci, enterococci, and Clostridium), and fungi [12][13][14][15] (Table 1). Contemporary case series indicate that Fournier's syndrome usually affects patients between the third and sixth decades of life with comorbidities such as debilitating conditions (e.g., malnutrition and sepsis); immunosuppression (e.g., diabetes mellitus, chronic alcoholism, underlying malignancy, AIDS, measles, chemotherapy, and leukemia); colorectal and urogenital diseases; postoperative complications (associated with urologic instrumentation use, herniorrhaphy, hemorrhoidectomy, orchiectomy, and prostatectomy), intravenous drug use; and trauma (e.g., local, mechanical, technical, and chemical) including bites, scratches, and vaginal and anal intercourse [15][16][17] .…”

Section: Introductionmentioning

confidence: 99%

Síndrome de Fournier: 10 anos de avaliação

Dornelas¹,

Corrêa²,

Barra³

et al. 2012

Rev. Bras. Cir. Plást.

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Background: Fournier's gangrene is a synergistic necrotizing fasciitis of the perineum and abdominal wall that develops in the scrotum and penis in men and the vulva and groin in women. This disease was initially believed to be idiopathic; however, recent studies have indicated that it is a serious condition caused by gram-positive, gram-negative, or anaerobic bacteria. It is often associated with severe and fatal systemic involvement. Methods: A retrospective study involving a chart review of 23 patients with Fournier's syndrome treated between January 2002 and January 2012 was conducted. Prompt treatment consisted of broad-spectrum antibiotic administration and serial debridement. The reconstruction techniques ranged from edge approximation via simple sutures to the use of flaps and grafts in cases with extensive lesions. Results: The skin and scrotal reconstruction techniques were effective in all cases, yielding satisfactory aesthetic results. Three (13%) patients died, including 2 patients who had previous illnesses and comorbidities. Conclusions: Although Fournier's syndrome is a serious disease, therapeutic measures such as prompt intervention, with early debridement and broad-spectrum antibiotic therapy, in a multidisciplinary approach is very effective for controlling the disease, enabling surgical reconstruction of the affected areas with a low mortality rate.Keywords: Fournier gangrene. Fasciitis, necrotizing. Reconstructive surgical procedures/ methods. RESUMO Introdução:A gangrena de Fournier é uma fasciite necrosante sinérgica do períneo e parede abdominal, que tem origem no escroto e pênis, no homem, e vulva e virilha, na mulher. O processo inicialmente foi descrito como idiopático, mas atualmente sabe-se que se trata de grave afecção causada por bactérias Gram positivas, Gram negativas ou anaeróbios, que pode levar a comprometimento sistêmico importante e, eventualmente, morte. Método: Foi realizado estudo retrospectivo, baseado na análise de prontuários médicos de 23 pacientes portadores de síndrome de Fournier, no período de janeiro de 2002 a janeiro de 2012. O tratamento dos pacientes incluiu intervenção precoce, com antibioticoterapia de largo espectro e desbridamentos consecutivos. O procedimento terapêutico empregado para a reconstrução variou desde a aproximação das bordas com sutura simples até uso de retalhos e enxertos, nas lesões extensas. Resultados: As técnicas de reparação cutânea foram eficientes e a reparação escrotal foi também efetiva em todos os casos, obtendo-se bons resultados estéticos. Houve 3 (13%) óbitos, 2 deles em pacientes com doenças pregressas This study was performed at the

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Section: Introductionmentioning

confidence: 99%

Síndrome de Fournier: 10 anos de avaliação

Dornelas¹,

Corrêa²,

Barra³

et al. 2012

Rev. Bras. Cir. Plást.

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“…Mauro 16 points out that this flap is technically simple, rarely shows ischemia, and provides excellent esthetic results. As a disadvantage, one can consider the limitation of the cross-sectional diameter and the skin elasticity of the medial thigh region.…”

Section: Resultsmentioning

confidence: 99%

Scrotal reconstruction with superomedial fasciocutaneous thigh flap

Mello

Júnior

2018

Rev. Col. Bras. Cir.

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“…Fournier's gangrene was first described by Hippocrates in the fifteenth century b.C, as a complication of erysipelas. Fournier's gangrene is a synergic necrotizing fasciitis of the perineum and of the abdominal wall, which has its origin the scrotum and in the penis, in the case of men, and in the vulva and groin, in the case of women (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) . The causes of Fournier's gangrene can also be associated to cuts, burns, abrasions, lacerations, contusions, animal bites, insect bites and subcutaneous and intravenous injections.…”

Section: Discussionmentioning

confidence: 99%

“…The synergic action of aerobic and anaerobic bacteria can be responsible for the frequent and fulminant evolution of the disease (16,21) . The quantitative and the types of microorganisms involved in Fournier's gangrene will be intimately related to the site of the infection, especially if it is on the abdominal wall, extremities and perineal.…”

Section: Discussionmentioning

confidence: 99%

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Brazilian scientific evidence on Fournier’s gangrene

Santos¹,

Vale²,

Reis³

et al. 2014

Rev Rene

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The objective of this study was to describe the Brazilian scientific reports published over the past twenty years on Fournier's gangrene. It is an integrative review conducted through incursions in the LILACS, MEDLINE, BDENF and Coleciona SUS databases with the descriptor 'Fournier's Gangrene'. Texts published between January 1994 and July 2014, in Portuguese, and freely available online were selected. According to the 14 articles found, the main symptoms of Fournier's gangrene include discomfort with painful sensations, high fever, edema, malaise, and sweating. In most cases erythema and blistering are observed, evolving into a wound. The clinical profile assists in the selection of empirical antimicrobial therapy even before the culture results. It was concluded that early diagnosis and appropriate and aggressive treatment are crucial in patient prognosis. There is still a shortage of Brazilian scientific production with a high power of evidence on the subject. Descriptors: Fournier Gangrene; Wounds and Injuries; Therapeutics; Review. Objetivou-se descrever os registros científicos brasileiros publicados nos últimos vinte anos acerca da gangrena de Fournier. Trata-se de uma revisão integrativa realizada por intermédio de incursões nas bases LILACS, MEDLINE, BDENF e Coleciona SUS com o descritor "Gangrena de Fournier". Foram selecionados os textos publicados entre janeiro de 1994 e julho de 2014, em português e disponíveis gratuitamente online. De acordo com os 14 artigos encontrados, os principais sintomas da gangrena de Fournier incluem desconforto com sensações dolorosas, febre elevada, edema, mal estar e sudorese. Na maior parte dos casos são observados eritema e formação de bolhas, evoluindo para uma ferida. O quadro clínico auxilia na seleção da terapêutica antimicrobiana empírica antes mesmo do resultado da cultura. Conclui-se que o diagnóstico precoce e o tratamento adequado e agressivo são determinantes no prognóstico do paciente. Ainda há escassez de produções científicas brasileiras com alto poder de evidência sobre o tema. Descritores: Gangrena de Fournier; Ferimentos e Lesões; Terapêutica; Revisão. El objetivo fue describir producciones brasileñas publicadas en los últimos veinte años acerca de la gangrena de Fournier. Revisión integradora realizada en las bases de datos LILACS, MEDLINE, BDENF y Colecciona SUS, con el descriptor "Gangrena de Fournier". Se seleccionaron textos publicados entre enero de 1994 y julio de 2014, en portugués y disponibles gratuitamente en Internet. Según los 14 artículos encontrados, los principales síntomas de la gangrena de Fournier incluyen malestar, con sensaciones dolorosas, fiebre alta, edema, malestar general, sudoración. En la mayor parte de los casos, son observados eritema y formación de bollas, surgiéndose una herida. El cuadro clínico ayuda en la selección de la terapia antimicrobiana empírica antes del resultado de la cultura. En conclusión, el diagnóstico precoz y el tratamiento apropiado y agresivo son cruciales en el pronóstico del paciente. Aún, hay escas...

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Retalho fasciocutâneo de região interna de coxa para reconstrução escrotal na síndrome de Fournier

Cited by 7 publications

References 4 publications

Síndrome de Fournier: 10 anos de avaliação

Síndrome de Fournier: 10 anos de avaliação

Scrotal reconstruction with superomedial fasciocutaneous thigh flap

Brazilian scientific evidence on Fournier’s gangrene

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