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Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée
Fournier gangrene is a rare and severe necrotizing fasciitis. It is burdened with high morbi-mortality, requiring early and massive medical and surgical management. Initial treatment is based on patient's resuscitation associated with surgical debridement. Subsequently, the main challenge is th...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The African Field Epidemiology Network
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987071/ https://www.ncbi.nlm.nih.gov/pubmed/29875951 http://dx.doi.org/10.11604/pamj.2018.29.70.14669 |
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author | Baraket, Oussama Triki, Wissem Ayed, Karim Hmida, Sonia Ben Lahmidi, Mohamed Amine Baccar, Abdelamjid Bouchoucha, Samy |
author_facet | Baraket, Oussama Triki, Wissem Ayed, Karim Hmida, Sonia Ben Lahmidi, Mohamed Amine Baccar, Abdelamjid Bouchoucha, Samy |
author_sort | Baraket, Oussama |
collection | PubMed |
description | Fournier gangrene is a rare and severe necrotizing fasciitis. It is burdened with high morbi-mortality, requiring early and massive medical and surgical management. Initial treatment is based on patient's resuscitation associated with surgical debridement. Subsequently, the main challenge is the healing process and its possible sequelae. Several therapeutic approaches are currently available to improve and accelerate the healing process. We conducted a retrospective study of 20 cases. The median age of our patients was 56 years. The study included 16 men and 7 women. Comorbidity was present in 15 patients. Antibiotic therapy was administered in all cases, with a median duration of 15 days. All patients underwent surgery. Iterative reviews were necessary in all patients, who needed, on average, 3 dressing changes. Colostomy was performed in 6 cases. Hyperbaric oxygen therapy was performed in 4 cases. Vacuum assisted closure was performed in 1 case. Soft tissue coverage was necessary in 2 cases. The mean duration of healing was 15 days with oxygen therapy versus 24 days in the absence of this treatment. The mean duration of hospitalization was 20 days. Four patients died. Healing process without sequelae is a therapeutic challenge. Despite the addition of new therapeutic approaches, outcomes are not satisfactory. However, multidisciplinary approach associated with oxygen therapy and vacuum assisted closure might improve patients outcomes. |
format | Online Article Text |
id | pubmed-5987071 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | The African Field Epidemiology Network |
record_format | MEDLINE/PubMed |
spelling | pubmed-59870712018-06-06 Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée Baraket, Oussama Triki, Wissem Ayed, Karim Hmida, Sonia Ben Lahmidi, Mohamed Amine Baccar, Abdelamjid Bouchoucha, Samy Pan Afr Med J Case Series Fournier gangrene is a rare and severe necrotizing fasciitis. It is burdened with high morbi-mortality, requiring early and massive medical and surgical management. Initial treatment is based on patient's resuscitation associated with surgical debridement. Subsequently, the main challenge is the healing process and its possible sequelae. Several therapeutic approaches are currently available to improve and accelerate the healing process. We conducted a retrospective study of 20 cases. The median age of our patients was 56 years. The study included 16 men and 7 women. Comorbidity was present in 15 patients. Antibiotic therapy was administered in all cases, with a median duration of 15 days. All patients underwent surgery. Iterative reviews were necessary in all patients, who needed, on average, 3 dressing changes. Colostomy was performed in 6 cases. Hyperbaric oxygen therapy was performed in 4 cases. Vacuum assisted closure was performed in 1 case. Soft tissue coverage was necessary in 2 cases. The mean duration of healing was 15 days with oxygen therapy versus 24 days in the absence of this treatment. The mean duration of hospitalization was 20 days. Four patients died. Healing process without sequelae is a therapeutic challenge. Despite the addition of new therapeutic approaches, outcomes are not satisfactory. However, multidisciplinary approach associated with oxygen therapy and vacuum assisted closure might improve patients outcomes. The African Field Epidemiology Network 2018-01-24 /pmc/articles/PMC5987071/ /pubmed/29875951 http://dx.doi.org/10.11604/pamj.2018.29.70.14669 Text en © Oussama Baraket et al. http://creativecommons.org/licenses/by/2.0/ The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Series Baraket, Oussama Triki, Wissem Ayed, Karim Hmida, Sonia Ben Lahmidi, Mohamed Amine Baccar, Abdelamjid Bouchoucha, Samy Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée |
title | Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée |
title_full | Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée |
title_fullStr | Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée |
title_full_unstemmed | Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée |
title_short | Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée |
title_sort | facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée |
topic | Case Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987071/ https://www.ncbi.nlm.nih.gov/pubmed/29875951 http://dx.doi.org/10.11604/pamj.2018.29.70.14669 |
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