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Fournier's gangrene

Maria Pittaka, Chrysanthos Georgiou, Petros Polyviou, Pantelis Kountourakis, Panayiotis Loizou, Ifigenia Constantinou, Demetris Andreopoulos, Vassilios P Vassiliou
We herein present a case of a 24-year-old patient with a cT4N+ rectal cancer who developed Fournier's gangrene (FG) 1 week after the completion of preoperative chemoradiotherapy. The patient was promptly referred to the surgical department where she was treated with antibiotics and repeated surgical debridement. FG is a rare and life-threatening situation that needs to be managed aggressively with no delay. The clinical image above is unique and characteristic of this clinical entity.
February 2018: Oxford Medical Case Reports
Gregory M Taylor, David V Hess
Fournier's gangrene, a rare polymicrobial infection that affects the genitals and perineum, can present as an insidious onset to a rapid and fulminant course. Early recognition, diagnosis, initiation of broad-spectrum antibiotics and prompt surgical treatment remain the foundation of management. If treatment is not initiated aggressively, the patient will likely rapidly deteriorate, leading to organ failure and death. We present the case of a 58-year-old diabetic female presenting febrile, hypoxic, with severe respiratory distress and evidence of septic shock, found to have necrotizing fasciitis of the entire right hemi-pelvis...
February 2018: Oxford Medical Case Reports
Feng-Shu Chang, Chieh Chou, Chuan-Yu Hu, Shu-Hung Huang
Background: The use of negative-pressure wound therapy (NPWT) for Fournier gangrene management is well documented; however, it is difficult to fixate GranuFoam dressings and maintain an airtight seal over the perineum area. We developed a simple method to facilitate GranuFoam fixation and improve airtight sealing. Methods: The Fournier's gangrene severity index (FGSI) score less than 9 was collected in from January 2015 to October 2016. All 13 patients underwent fasciotomy, and NPWT was applied directly on fasciotomy wounds after the debridement of infected tissue...
January 2018: Plastic and Reconstructive Surgery. Global Open
Djoney Rafael Dos-Santos, Ulisses Luiz Tasca Roman, André Pereira Westphalen, Keli Lovison, Fernando Antonio C Spencer Neto
OBJECTIVE: to analyze the profile of patients with Fournier's gangrene treated in a public tertiary hospital in western Paraná State. METHODS: we conducted a cross-sectional, retrospective and descriptive study of patients with Fournier's gangrene treated between January 2012 and November 2016. RESULTS: there were 40 patients with Fournier's gangrene treated in the period, 29 (72.5%) men and 11 (27.5%) women. The mean age was 51.7±16.3 years...
2018: Revista do Colégio Brasileiro de Cirurgiões
Daniel Francisco Mello, Americo Helene Júnior
OBJECTIVE: to describe the use of a superomedial fasciocutaneous thigh flap for scrotal reconstruction in open areas secondary to the surgical treatment of perineal necrotizing fasciitis (Fournier's gangrene). METHODS: retrospective analysis of cases treated at the Plastic Surgery Service of Santa Casa de Misericórdia, São Paulo, from 2009 to 2015. RESULTS: fifteen patients underwent scrotal reconstruction using the proposed flap. The mean age was 48...
2018: Revista do Colégio Brasileiro de Cirurgiões
Margaret Lauerman, Olga Kolesnik, Habeeba Park, Laura S Buchanan, William Chiu, Ronald B Tesoriero, Deborah Stein, Thomas Scalea, Sharon Henry
Necrotizing soft tissue infection of the perineum, or Fournier's gangrene (FG), is a morbid and mortal diagnosis. Despite the severity of FG, the optimal definitive wound closure strategy is unknown, as are long-term wound outcomes. A retrospective review was performed over a 3-year period at a single trauma center. Patients were managed according to our institutional approach focusing on primary wound closure and secondary intention healing in residual wounds. Overall 168 patients were included. Complete primary wound closure was accomplished in 39...
January 1, 2018: American Surgeon
Ahmed Hassan El-Sabbagh
Background: Fournier's gangrene is a necrotizing fasciitis caused by mixed aerobic and anaerobic bacteria and results in loss of skin and subcutaneous tissue in the perineal area. Coverage of testis varies from closure of the defect primarily, burying inside the thigh, using the remnants of the scrotum for tissue expansion and coverage by flaps. In this manuscript, scrotal advancement flaps and pudendal thigh flaps were used for coverage of the testis unilaterally or bilaterally according to the size of the defect following Fournier gangrene...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Kiyoko Fukui, Masaki Fujioka, Satoko Ishiyama
INTRODUCTION: Fournier's gangrene (FG) is a type of necrotizing fasciitis of the perineum and scrotum that is characterized by very rapid progression. Sacral pressure ulcers are one of the causes of FG. CASE REPORT: An 85-year-old man was referred to the National Hospital Organization Nagasaki Medical Center (Ohmura City, Japan) with a diagnosis of FG extending to the retroperitoneum caused by a sacral pressure ulcer. Immediate debridement was performed; however, it was not possible to remove all necrotic tissue from the pelvis...
January 2018: Wounds: a Compendium of Clinical Research and Practice
Adarsh S Manjunath, Matthias D Hofer
Urologic emergencies can involve the kidneys, ureters, bladder, urethra, penis, scrotum, or testicles. History and physical examination are essential to diagnosis, whereas imaging is increasingly used to confirm diagnoses. Acute urinary retention should be relieved with Foley placement. Penile emergencies include paraphimosis, which can be treated by foreskin reduction, whereas penile fracture and priapism require urologic intervention. Fournier gangrene and testicular torsion are scrotal emergencies requiring emergent surgery...
March 2018: Medical Clinics of North America
Partha Pratim Deb, Arpan Choudhary, Ranjan Kumar Dey, Ranjit Kumar Das
skin and subcutaneous tissue. Penis may be secondarily affected in some cases; however, primary isolated involvement of penis is rare. A 48-year male smoker presented with pain and blackish discoloration of the distal part of penis for the last 4 days which developed following rupture of a papulo-vesicular lesion over the prepuce of penis. It rapidly progressed to involve half of the skin of the penis. The patient was hospitalized and broad spectrum antibiotics were administered parenterally. Emergency wound debridement and urinary diversion by suprapubic cystostomy was done...
February 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Bolesław Kuzaka, Marta M Wróblewska, Tomasz Borkowski, Dariusz Kawecki, Piotr Kuzaka, Grażyna Młynarczyk, Piotr Radziszewski
BACKGROUND Fournier's gangrene (FG) is a fulminant form of infective, polymicrobial, necrotizing fasciitis of the perineal, genital, and perianal regions. It commonly affects men, but women and children may also develop this type of tissue necrosis. MATERIAL AND METHODS This study is a retrospective analysis of the management of 13 cases of Fournier's gangrene, diagnosed from among about 45 000 patients (men, women, and children) treated in the Department of General, Oncological, and Functional Urology (Medical University of Warsaw) from 1995 to 2013...
January 28, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
David F Penson
No abstract text is available yet for this article.
August 2017: Journal of Urology
Apoorv Goel, Shalabh Gupta, Ayush Agarwal, Nitin Shiwach, Vishal Chawda, Tripta S Bhagat
No abstract text is available yet for this article.
January 2018: Tropical Doctor
Saum B Ghodoussipour, Daniel Gould, Jacob Lifton, Ido Badash, Aaron Krug, Gus Miranda, Jeffrey Loh-Doyle, Joseph Carey, Hooman Djaladat, Leo Doumanian, David Ginsberg
BACKGROUND: There is no contemporary scoring system to predict hospital length of stay and morbidity in Fournier's gangrene. A retrospective study was conducted to formulate a scoring system to predict duration of hospitalization, resource utilization, need for reconstruction, morbidity and mortality. METHODS: A retrospective chart review was performed on 54 patients treated for FG from 2010-2016 at LAC+USC Medical Center, the largest public hospital in Los Angeles County...
December 14, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Harsh Sheth, Shilpa Ashutosh Rao, Karthik Venkataramani
Fournier's gangrene is a fatal necrotising fasciitis of the perineum, genitals and lower abdomen. Patients often need an aggressive surgical debridement, and in few cases, a diverting colostomy. We report the case of a 70-year-old man with multiple comorbidities diagnosed with Fournier's gangrene, who underwent debridement and had a wound complication due to faecal contamination. A novel, self-retaining rectal device was used to perform faecal diversion, which subsequently showed wound healing within a week, hence avoiding the need of a colostomy...
December 22, 2017: BMJ Case Reports
M Wähmann, M Wähmann, F Schütz, C Sohn, S Schott, T Kremer, J F Hernekamp, U Kneser
Necrotizing fasciitis (NF) is a rare soft tissue infection characterized by rapidly progressing necroses and a high mortality. Prompt diagnosis and immediate medical treatment including radical debridement and broad spectrum antibiotics are the key to successful management. We report on a 46-year-old diabetic female who developed extensive, deep necroses in the perineal area and proximal thighs within a few days. After initial gynaecological consultation, she was transferred directly to our department. Due to the suspicion of NF, an immediate radical debridement was performed...
December 2017: Journal of Surgical Case Reports
Nalisson Marques Pereira, Luciano Santos Feitosa, Ricardo Scarparo Navarro, Dora Inés Kozusny-Andreani, Naacia Marques Pereira Carvalho
Fournier's Gangrene (FG) is an infectious disease caused by several synergic microbes, with high morbidity and mortality rates; therefore, the search for new less invasive and mutilating treatments, with faster recovery, has been proposed. Surgical intervention, the use of several systemic and topic antibiotics, and hyperbaric oxygen therapy are currently the best approach for the treatment of these patients. The use of Photodynamic Inactivation (PDI) aims to lower morbidity and mortality, by reducing bacterial microbiota and speeding wound healing...
January 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Angela M Ingraham, Hee Soo Jung, Amy E Liepert, Charles Warner-Hillard, Caprice C Greenberg, John E Scarborough
BACKGROUND: Whether patients with necrotizing soft tissue infections (NSTI) who presented to under-resourced hospitals are best served by immediate debridement or expedited transfer is unknown. We examined whether interhospital transfer status impacts outcomes of patients requiring emergency debridement for NSTI. METHODS AND MATERIALS: We conducted a retrospective review studying patients with an operative diagnosis of necrotizing fasciitis, Fournier's gangrene, or gas gangrene in the 2010-2015 American College of Surgeons National Surgical Quality Improvement Program Participant Use Data Files...
December 2017: Journal of Surgical Research
Bryan B Voelzke, Judith C Hagedorn
Necrotizing fasciitis is a severe type of necrotizing soft tissue infection involving the superficial fascia and subcutaneous tissues. Fournier gangrene, a type of necrotizing fasciitis, affects the genitalia or perineum. Although a rare health condition, Fournier gangrene can result in significant morbidity and unnecessary mortality following delay in diagnosis and management. We provide a review of relevant presenting features to aid diagnosis and allow timely surgical management of this serious infectious condition...
November 13, 2017: Urology
Tao Wang, Gang Zhao, Yong-Jun Rui, Jing-Yi Mi
RATIONALE: Necrotizing fasciitis (NF), characterized by widespread fascial necrosis, is a rare disease in clinic. Fournier gangrene (FG) is a special type of NF involved of perineum and scrotum. To our knowledge, no article has reported on bilateral femoral posterior neurocutaneous perforater flap treating for FG. PATIENT CONCERNS: A 61-year-old Chinese male complained of perineal skin necrosis for 19 days. The patient received treatment in other hospital due to chronic bronchitis on April 15th and body temperature ranged from 38 to 39 °C...
November 2017: Medicine (Baltimore)
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