Fournier’s gangrene. Immediate diagnosis and multimodality treatment is the cornerstone for successful outcome

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COD: 563-568 Categorie: ,

Spiros Rizos, Dimitrios K. Filippou,, Nicolas Condilis, Georgios Filippou, Argiro Trigka, Panagiotis Skandalakis, Antonios Vezakis

Ann. Ital. Chir., 2005; 76: 563-567

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BACKGROUND: Fournier’s gangrene is a synergistic necrotic fasciitis or myositis of genitalia, perineum and abdominal wall.
Several etiologic factors have been reported, microorganisms isolated and co-morbidity factors identified. Immediate and
accurate diagnosis decreases mortality rate, which ranges from 3-67%. Aggressive resuscitation and surgical debridement
consist the appropriate treatment.
MATERIAL AND METHODS: Six cases of Fournier’s gangrene treated the last ten years were reviewed. Three of them presented
with mild infection while the other three with severe. The mean time interval between first symptoms and initial
treatment was 2.1 days. The diagnosis was set immediately and the treatment included fluid-electrolyte resuscitation,
aggressive surgical debridement, and broad-spectrum antibiotics administration.
RESULTS: All patients survived. The defects healed by second intention in four patients and only in two patients specific
plastic reconstructive techniques were required. Hyperbaric oxygenation administrated in one patient induced surprisingly
the healing of the lesion.
CONCLUSIONS: The Authors confirm that Fournier’s gangrene is a rare and potentially fatal disease. Early suspicion, accurate
diagnosis and multimodality treatment including aggressive surgical intervention are essential for successful outcome.

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