Vacuum-assisted closure device in the postoperative wound care for Fournier's gangrene: a systematic review

Franco-Buenaventura, Daniela; García‐Perdomo, Herney Andrés

doi:10.1007/s11255-020-02705-6

Cited by 21 publications

(13 citation statements)

References 20 publications

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“…In the same study, the severity of pain during dressing was compared, and the VAS score was reported to be statistically significantly lower in the VAC group. A recently published systematic review reported that VAC therapy requires fewer dressing changes, less pain, and less analgesic [22]. In our study, daily analgesic requirement, number of dressings and VAS score during dressing were reported to be statistically significantly lower in the VAC therapy group than in the conventional dressing group.…”

Section: Discussionsupporting

confidence: 50%

Evaluation of the effectiveness of vacuum-assisted closure in the treatment of Fournier gangrene

2021

JOMH

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Background and objective: To evaluate the effectiveness of vacuum-assisted closure (VAC) in the treatment of Fournier gangrene (FG). Material and methods: Forty-eight male patients treated for Fournier gangrene were included in the study. The patients were divided into two groups (Group I: conventional dressing, Group II: VAC therapy). Characteristics of the patients, laboratory parameters, number of debridement procedures, daily number of dressings, visual analogue scale (VAS) during dressing, analgesic requirement, colostomy requirement, time from the first debridement to wound closure, wound closure method, length of hospital stay, and mortality rates were compared. Results: Group I comprised 33 patients and Group II comprised 15 patients. The number of dressings, VAS score and daily analgesic requirement were statistically significantly lower in Group II (p < 0.05) than in Group I. The number of debridement procedures, colostomy requirement, orchiectomy rate, time from first debridement to wound closure, length of hospital stay, wound closure method and mortality rate were similar between these two groups (p > 0.05). Conclusion: The clinical results of conventional dressing and VAC therapy were similar for treating FG. VAC therapy is an effective postoperative wound care method that offers less requirement for dressing changes, less pain, less analgesic requirement and more patient satisfaction compared to conventional dressing.

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Section: Discussionsupporting

confidence: 50%

Evaluation of the effectiveness of vacuum-assisted closure in the treatment of Fournier gangrene

2021

JOMH

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“…In cases of FG with deep involvement of the perineum, VAC therapy,4 faecal5 and urinary diversions (UDs) are of paramount importance to avoid contamination and allow for the healing of tissues.…”

Section: Discussionmentioning

confidence: 99%

Fournier’s gangrene with prostatic and bladder trigone colliquation: a suggested treatment algorithm

et al. 2022

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Fournier’s gangrene (FG) is an infectious necrotising fasciitis of the perineum and genital regions with a high mortality rate. We report the case of a man in his 70s with FG who presented with bladder trigone and prostate colliquation. Bulbar and penile urethra were also injured with multiple fenestrations. Bilateral percutaneous nephrostomy positioning followed by the placement of occluding ureteral catheters preceded the surgical debridement of the necrotic tissues and protective colostomy. There followed periodic sessions of surgical debridement and VAC therapy. The persistent perineal urinary leak required the crafting of a suprapubic surgical cystostomy with bladder neck obliteration through double-layer raphy. The cystostomy maintained the healing tissues free from the constant and damaging urine action. This report describes the successful multistep approach of an FG with deep involvement and colliquation of the bladder neck and prostate reaching the Denonvilliers fascia that ensured the correct healing of tissues.

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“…107,108 However, the use of VAC may prevent clinicians from observing wounds clearly and prolong the stay of hospital, so the equipment should be changed every 72 to 96 hours. 95,109,110 VAC was often used in patients with large skin defects, which can act as temporary closure method to prepare for underlying secondary reconstruction. Moreover, latest retrospective multi-institutional cohort study found that the number of pathogens in FG patients is positively related to the use of VAC, which further supported the use of VAC in FG patients.…”

Section: Hyperbaric Oxygen Therapy (Hbot)mentioning

confidence: 99%

Progress in Multidisciplinary Treatment of Fournier’s Gangrene

Zhang¹,

Shi²,

Chen³

et al. 2022

IDR

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Fournier's gangrene (FG) is a life-threatening and special form of necrotizing fasciitis, characterized by occult onset, rapid progress and high mortality, occurring mainly in men over 50 years of age. Risk factors of FG include diabetes, HIV infection, chronic alcoholism and other immunosuppressive state. FG was previously considered as an idiopathic disease, but in fact, three quarters of the infections originated from the skin, urethra and gastrointestinal tract. Initial symptoms of FG are often inconsistent with severity and can progress promptly to fatal infection. Although the treatment measures of FG have been improved in recent years, the mortality does not seem to have decreased significantly and remains at 20% -30%. The time to identify FG and the waiting period before surgical debridement are directly related to the prognosis. Therefore, in addition to the combination of intensive fluid resuscitation and broad-spectrum antibiotics, treatment of FG should particularly emphasize the importance of early surgical debridement assisted with fecal diversion and skin reconstruction when necessary. This paper is to briefly summarize the progress in the definition, epidemiology, clinical manifestations, diagnosis, treatment and prognosis of Fournier's gangrene in recent years, more importantly, illustrates the importance of multidisciplinary cooperation in the management of FG.

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Vacuum-assisted closure device in the postoperative wound care for Fournier's gangrene: a systematic review

Cited by 21 publications

References 20 publications

Evaluation of the effectiveness of vacuum-assisted closure in the treatment of Fournier gangrene

Evaluation of the effectiveness of vacuum-assisted closure in the treatment of Fournier gangrene

Fournier’s gangrene with prostatic and bladder trigone colliquation: a suggested treatment algorithm

Progress in Multidisciplinary Treatment of Fournier’s Gangrene

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