Necrotizing soft tissue infections (NSTIs) Literary review and description of a Fournier syndrome case

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COD: 111-116 Categorie: ,

Adelmo Gubitosi, Giancarlo Moccia, Roberto Ruggiero, Giovanni Docimo, Fabrizio Foroni, Emanuela Esposito, Giuseppe Villaccio, Alessandro Esposito, Ettore Agresti, Massimo Agresti

Ann. Ital. Chir., 2013 84: 111-115
aheadofprint 3 August 2012

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A 62 y.o. male with tight fimosis, swelling, redness, pain on palpating and necrosis of the penis and scrotum was admitted
in our clinic, (FGSI = 6) with periferic vasculopathy; and diabetes mellitus type II and he was in dialysis treatment
before the hospitalization. The patient was HCV affected. In 24 hours he underwent radical surgical debridement
with excision of all necrotic material from penis and scrotum up to the subdermal layer and tissue of doubtful viability
for about 75% of the skin and circumcision. In third, fifth and seventh postoperative days he underwent to local
infusion of autologous PLT growth factors. The patient was discharged in 9th postoperative day and FGSI was still 6;
the skin and subdermal tissue was barely reskined, with low homogeneous granulation, edema was heavely reduced.
In our case, deviation from homeostasis status at admission was the main worrying factor. We found that diabetes mellitus
and renal dysfunction at admission was also important risk factor for FG. “E.Coli” was the most common organism
isolated from patient wound cultures. The FGSI is an objective and easy to apply score method to quantify the
metabolic status and can be used to evaluate therapeutic options and assess results.

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