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A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region
BACKGROUND: To describe the clinical characteristics and management for Fournier’s gangrene. Experience summary and literature references are provided for future treatment improvement. METHODS: We retrospectively reviewed the cases diagnosed with Fournier’s gangrene in our department from June 2016...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602356/ https://www.ncbi.nlm.nih.gov/pubmed/33126879 http://dx.doi.org/10.1186/s12893-020-00916-3 |
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author | Zhang, Nan Yu, Xin Zhang, Kai Liu, Tongjun |
author_facet | Zhang, Nan Yu, Xin Zhang, Kai Liu, Tongjun |
author_sort | Zhang, Nan |
collection | PubMed |
description | BACKGROUND: To describe the clinical characteristics and management for Fournier’s gangrene. Experience summary and literature references are provided for future treatment improvement. METHODS: We retrospectively reviewed the cases diagnosed with Fournier’s gangrene in our department from June 2016 to June 2019. Clinical data, including manifestation, diagnosis, treatment and outcomes for Fournier’s gangrene were presented. RESULTS: There were 12 patients enrolled in this paper, with the average age of 60 years old. It showed a male predominance with male-to-female ratio of 6:1. The average of laboratory risk indicator for necrotizing fasciitis (LRINEC) score was 10.1. Diabetes mellitus was the main predisposing disease. 11 patients received emergency debridement and 1 patient died of sepsis on the 2nd day after admission. The mortality rate was 8.3%. 6 cases developed complications, including sepsis, pneumonia, renal and heart failure. Negative pressure wound therapy (NPWT) was applied in 10 cases, while the rest 1 received normal daily dressing changes because of fecal contamination. Flaps were utilized in 2 patients to cover the defect, including one with advancement flap and one with pudendal-thigh flap, while others received secondary suture, secondary healing, skin graft or combined management. No relapse was observed during the follow-up visits. CONCLUSIONS: Fournier’s gangrene is a life-threatening infection that requires early diagnosis and surgery intervention. The predisposing disease, clinical manifestation and LRINEC score should be taken into comprehensive consideration, which is helpful for timely diagnosis. Moreover, further successful treatment depends on the aggressive debridement, broad-spectrum antibiotics therapy, wound management and closure choice. |
format | Online Article Text |
id | pubmed-7602356 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-76023562020-11-02 A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region Zhang, Nan Yu, Xin Zhang, Kai Liu, Tongjun BMC Surg Research Article BACKGROUND: To describe the clinical characteristics and management for Fournier’s gangrene. Experience summary and literature references are provided for future treatment improvement. METHODS: We retrospectively reviewed the cases diagnosed with Fournier’s gangrene in our department from June 2016 to June 2019. Clinical data, including manifestation, diagnosis, treatment and outcomes for Fournier’s gangrene were presented. RESULTS: There were 12 patients enrolled in this paper, with the average age of 60 years old. It showed a male predominance with male-to-female ratio of 6:1. The average of laboratory risk indicator for necrotizing fasciitis (LRINEC) score was 10.1. Diabetes mellitus was the main predisposing disease. 11 patients received emergency debridement and 1 patient died of sepsis on the 2nd day after admission. The mortality rate was 8.3%. 6 cases developed complications, including sepsis, pneumonia, renal and heart failure. Negative pressure wound therapy (NPWT) was applied in 10 cases, while the rest 1 received normal daily dressing changes because of fecal contamination. Flaps were utilized in 2 patients to cover the defect, including one with advancement flap and one with pudendal-thigh flap, while others received secondary suture, secondary healing, skin graft or combined management. No relapse was observed during the follow-up visits. CONCLUSIONS: Fournier’s gangrene is a life-threatening infection that requires early diagnosis and surgery intervention. The predisposing disease, clinical manifestation and LRINEC score should be taken into comprehensive consideration, which is helpful for timely diagnosis. Moreover, further successful treatment depends on the aggressive debridement, broad-spectrum antibiotics therapy, wound management and closure choice. BioMed Central 2020-10-30 /pmc/articles/PMC7602356/ /pubmed/33126879 http://dx.doi.org/10.1186/s12893-020-00916-3 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Zhang, Nan Yu, Xin Zhang, Kai Liu, Tongjun A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region |
title | A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region |
title_full | A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region |
title_fullStr | A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region |
title_full_unstemmed | A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region |
title_short | A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region |
title_sort | retrospective case series of fournier’s gangrene: necrotizing fasciitis in perineum and perianal region |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602356/ https://www.ncbi.nlm.nih.gov/pubmed/33126879 http://dx.doi.org/10.1186/s12893-020-00916-3 |
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