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ORIGINAL ARTICLE
Year : 2012  |  Volume : 2  |  Issue : 2  |  Page : 74-78

Fournier's gangrene: A study of 18 cases


Department of General Surgery, Padmashree Dr. D. Y. Patil Hospital and Research Centre, PIMPRI, Pune, Maharashtra, India

Correspondence Address:
Neha Jindal
Department of General Surgery, Padmashree Dr. D. Y. Patil Hospital and Research Centre, Sant Tukaram Nagar, Pimpri, Pune 411 018, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9596.110021

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Background: Fournier's gangrene (FG) refers to necrotizing fasciitis affecting the perineal, rectal or genital areas. This can have a fulminant presentation, and its clinical course is unpredictable. It can be fatal unless there is prompt recognition and aggressive surgical treatment. We report our experience and results in the management of FG. Materials and Methods: We conducted a prospective analysis of cases of FG presenting to our institute from April 2007 to September 2009. All patients with signs and symptoms of FG were admitted and evaluated. A policy of aggressive surgical debridement under the cover of broad spectrum antibiotics was adopted, often in multiple sittings. Supportive therapy was also provided. Skin grafting and thigh pouch implantation were undertaken where indicated. Results: There were a total of 18 patients. Seven patients were in the age group of 50-59 years. There was delay of 11-15 days in reporting after onset of symptoms in 44.4% of cases. The main pre-disposing risk factors were age above 50 years (61.1%) and diabetes mellitus (33.3%). The route of infection was mostly cutaneous (27.7%). All infections were polymicrobial aerobic infections, and the commonest organisms were Escherichia coli and Klebsiella species. Aggressive surgical debridements were done, often in multiple sittings. The average number of procedures per patient was 3.27 with a range of 2-4. Conclusion: Early and aggressive surgical management are essential to ensure a successful outcome in FG.


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