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What Has Changed in the History of Fournier’s Gangrene Treatment: The Single-Center Experience

OBJECTIVES: Fournier’s gangrene (FG) is a rapidly progressive infection that requires emergent intervention. Wound closure is an important treatment step after surgery, and vacuum-assisted closure (VAC) can be preferred as an alternative method for wound closure. FG severity index (FGSI) scales that...

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Autores principales: Kutsal, Cemil, Baloglu, Ibrahim Halil, Turkmen, Nihat, Haciosmanoglu, Taner, Albayrak, Ahmet Tevfik, Cekmece, Ali Emre, Guney, Soner
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Med Bull Sisli Etfal Hosp 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10098399/
https://www.ncbi.nlm.nih.gov/pubmed/37064849
http://dx.doi.org/10.14744/SEMB.2023.90757
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author Kutsal, Cemil
Baloglu, Ibrahim Halil
Turkmen, Nihat
Haciosmanoglu, Taner
Albayrak, Ahmet Tevfik
Cekmece, Ali Emre
Guney, Soner
author_facet Kutsal, Cemil
Baloglu, Ibrahim Halil
Turkmen, Nihat
Haciosmanoglu, Taner
Albayrak, Ahmet Tevfik
Cekmece, Ali Emre
Guney, Soner
author_sort Kutsal, Cemil
collection PubMed
description OBJECTIVES: Fournier’s gangrene (FG) is a rapidly progressive infection that requires emergent intervention. Wound closure is an important treatment step after surgery, and vacuum-assisted closure (VAC) can be preferred as an alternative method for wound closure. FG severity index (FGSI) scales that can be developed to evaluate the prognosis in FG. This study aims to compare VAC therapy, which was used and developed in the historical development of FG therapy, with conventional wound dressing (CWD). METHODS: Data on who 85 patients treated at our hospital with a diagnosis of FG from January 2010 to July 2021. In the VAC group, the vacuum device was applied in a sealed manner. In the CWD group, mesh dressing was prepared. The VAC device was adjusted to subatmospheric pressure. Broad-spectrum antibiotics were administered to all patients during their follow-up. During the follow-up, as necrotic tissues were detected, redebridements were performed by providing appropriate analgesia and anesthesia. Demographic data of the patients were collected on the records. The clinical and laboratory data were obtained from the records at the 1st h, 72 h, and 1st week FSGI values were calculated. In statistical analysis, continuous variables were expressed as mean±standard deviation, ordinal variables were expressed as median [IQR], and categorical variables were expressed as n (%). In intergroup analyses, student’s t-test was used if the data were normally distributed. If it did not show normal distribution, the Mann–Whitney U-test was applied. RESULTS: Fifty-five patients who were diagnosed with FG were included in our study. CWD was applied to 18 patients, and VAC was applied to 37 patients. The mean 1st h FGSI of the patients who used VAC was 7.05 (3.75–8), and the patients who had CWD were 5.5 (5–9) (p=0.067). Mean 72nd-h FGSI was found to be 5.35 (3.5–7) in the VAC group and 5.33 (4.75–6.25) in the CWD group (p=0.714). The mean 1st-week FGSI VAC group was 2.97 (1–5), and in the CWD group, it was 5 (4–6) (p=0.0001). CONCLUSION: VAC significantly reduces the length of hospital stay. In our analysis, both groups observed a significant difference between the 1st-week FGSIs. This is the first study to evaluate FGSI, which is an essential predictor of the effect of VAC therapy used in treating FG. In the history of FG treatment, CWD has been replaced by VAC.
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spelling pubmed-100983992023-04-14 What Has Changed in the History of Fournier’s Gangrene Treatment: The Single-Center Experience Kutsal, Cemil Baloglu, Ibrahim Halil Turkmen, Nihat Haciosmanoglu, Taner Albayrak, Ahmet Tevfik Cekmece, Ali Emre Guney, Soner Sisli Etfal Hastan Tip Bul Original Research OBJECTIVES: Fournier’s gangrene (FG) is a rapidly progressive infection that requires emergent intervention. Wound closure is an important treatment step after surgery, and vacuum-assisted closure (VAC) can be preferred as an alternative method for wound closure. FG severity index (FGSI) scales that can be developed to evaluate the prognosis in FG. This study aims to compare VAC therapy, which was used and developed in the historical development of FG therapy, with conventional wound dressing (CWD). METHODS: Data on who 85 patients treated at our hospital with a diagnosis of FG from January 2010 to July 2021. In the VAC group, the vacuum device was applied in a sealed manner. In the CWD group, mesh dressing was prepared. The VAC device was adjusted to subatmospheric pressure. Broad-spectrum antibiotics were administered to all patients during their follow-up. During the follow-up, as necrotic tissues were detected, redebridements were performed by providing appropriate analgesia and anesthesia. Demographic data of the patients were collected on the records. The clinical and laboratory data were obtained from the records at the 1st h, 72 h, and 1st week FSGI values were calculated. In statistical analysis, continuous variables were expressed as mean±standard deviation, ordinal variables were expressed as median [IQR], and categorical variables were expressed as n (%). In intergroup analyses, student’s t-test was used if the data were normally distributed. If it did not show normal distribution, the Mann–Whitney U-test was applied. RESULTS: Fifty-five patients who were diagnosed with FG were included in our study. CWD was applied to 18 patients, and VAC was applied to 37 patients. The mean 1st h FGSI of the patients who used VAC was 7.05 (3.75–8), and the patients who had CWD were 5.5 (5–9) (p=0.067). Mean 72nd-h FGSI was found to be 5.35 (3.5–7) in the VAC group and 5.33 (4.75–6.25) in the CWD group (p=0.714). The mean 1st-week FGSI VAC group was 2.97 (1–5), and in the CWD group, it was 5 (4–6) (p=0.0001). CONCLUSION: VAC significantly reduces the length of hospital stay. In our analysis, both groups observed a significant difference between the 1st-week FGSIs. This is the first study to evaluate FGSI, which is an essential predictor of the effect of VAC therapy used in treating FG. In the history of FG treatment, CWD has been replaced by VAC. Med Bull Sisli Etfal Hosp 2023-03-21 /pmc/articles/PMC10098399/ /pubmed/37064849 http://dx.doi.org/10.14744/SEMB.2023.90757 Text en ©Copyright 2023 by The Medical Bulletin of Sisli Etfal Hospital https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Original Research
Kutsal, Cemil
Baloglu, Ibrahim Halil
Turkmen, Nihat
Haciosmanoglu, Taner
Albayrak, Ahmet Tevfik
Cekmece, Ali Emre
Guney, Soner
What Has Changed in the History of Fournier’s Gangrene Treatment: The Single-Center Experience
title What Has Changed in the History of Fournier’s Gangrene Treatment: The Single-Center Experience
title_full What Has Changed in the History of Fournier’s Gangrene Treatment: The Single-Center Experience
title_fullStr What Has Changed in the History of Fournier’s Gangrene Treatment: The Single-Center Experience
title_full_unstemmed What Has Changed in the History of Fournier’s Gangrene Treatment: The Single-Center Experience
title_short What Has Changed in the History of Fournier’s Gangrene Treatment: The Single-Center Experience
title_sort what has changed in the history of fournier’s gangrene treatment: the single-center experience
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10098399/
https://www.ncbi.nlm.nih.gov/pubmed/37064849
http://dx.doi.org/10.14744/SEMB.2023.90757
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