Document Detail


Genital Fournier's gangrene: experience with 38 patients.
MedLine Citation:
PMID:  8650874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Fournier's gangrene (FG) is an extensive fulminant infection of the genitals, perineum, or the abdominal wall. We report our experience with the management of this difficult infectious disease. METHODS: Thirty-eight patients were admitted with the diagnosis of FG between May 1993 and May 1995. All patients were treated with broad-spectrum triple antimicrobial therapy, broad debridement, exhaustive cleaning, and application of unprocessed honey dressings. Patients then underwent split-thickness skin grafts or delayed closure as needed. RESULTS: Patient ages ranged between 33 and 86 years (mean, 54) with a mean hospital stay of 17 days (range, 1 to 45). Sixty-six percent of the patients were diabetic, 16% had previous orchiepididymitis, and 5% had scrotal and urethral trauma. All the patients underwent surgical debridement and application of unprocessed honey to the wound. Cystostomy was performed in 60% of the patients and 21% underwent orchiectomy of the affected side. Free skin grafts were applied to 6 patients (16%) and the remaining wounds, once clean, were approximated. One patient died as a result of severe metabolic acidosis and sepsis. CONCLUSIONS: The management of this infectious entity should be aggressive. Patients with FG need extensive debridement and cystostomy or colostomy when necessary. Broad-spectrum triple antimicrobial regimen and aggressive debridement are mandatory. Topical application of unprocessed honey is beneficial to the healing process. A minority of patients require split-thickness skin grafts on denuded areas.
Authors:
M J Hejase; J E Simonin; R Bihrle; C L Coogan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Urology     Volume:  47     ISSN:  0090-4295     ISO Abbreviation:  Urology     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-07-22     Completed Date:  1996-07-22     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  734-9     Citation Subset:  IM    
Affiliation:
Department of Urology, Hospital General de Zona no. 33, IMSS, Monterry, Nuevo Leon, Mexico.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Fournier Gangrene / therapy*
Genital Diseases, Male / therapy
Humans
Male
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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