scholarly journals Fournier’s gangrene: a retrospective review of management outcomes and seasonal variations of clinical presentation

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Ikenna I. Nnabugwu ◽  
Okechukwu O. Onumaegbu ◽  
Louis T. Okolie
Keyword(s):  
Hospital Admission ◽  
Seasonal Variations ◽  
Medical Records ◽  
Vital Signs ◽  
Skin Grafting ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Management Interventions ◽  
Split Skin Grafting

Abstract Background To review retrospectively the outcomes of management of Fournier’s gangrene (FG) and to assess for possible seasonal variations in clinical presentations of FG to a referral hospital in a tropical African country. Methods The medical records of patients who presented with FG from February 2012 to December 2019 were reviewed. Of interest were age of patient, vital signs at presentation, site of gangrene, duration of hospital admission, and management interventions deployed. Analysis was with SPSS® version 21. Results Twenty-three of 28 medical records could be analyzed. Median Fournier’s Gangrene Severity Index (FGSI) was 5 (IQR:3–10), the median Uludag-FGSI (UFGSI) was 7 (IQR:4–14). In 82.6%, the scrotum was the site of onset; in 8.7%, the lesion had spread beyond the pelvis. Diabetes mellitus (30.4%), HIV infection (13.0%) and nephropathy (17.4%) were identified co-morbidities. There were 2.4 ± 1.0 debridement sessions and 1.5 ± 1.3 transfused units of blood per patient. In 60.9%, the wound edges were undermined and apposed; in 17.4%, split skin grafting or fascio-cutaneous flap cover was deployed. In 17.4%, satisfactory wound closure needed more than 1 theater session. Mean duration of hospital admission was 51.4 ± 19.4 days. No mortality was recorded. Majority (91.2%) presented in hot, dry months of October through March with peak in December. No case presented in the wet months of May through September. Conclusion Meager resources notwithstanding, FG management outcomes are generally satisfactory. Furthermore, FG is observed to present mostly in the hot, dry months of the year in the 8 years under review.

scholarly journals THE USE FGSI AS PREDICTIVE OF UROLOGICAL SIRS PATIENTS

2013 ◽  
Vol 20 (2) ◽  
Author(s):  
Basuki Bambang Purnomo
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Vital Signs ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Systemic Inflammatory Response ◽  
Outcome Predictor ◽  
Fournier's Gangrene ◽  
Laboratory Findings ◽  
Significant Difference

Objective: To demonstrate the usefulness of Fournier’s Gangrene Severity Index (FGSI) score for differentiating the outcome between Systemic Inflammatory Response Syndrome (SIRS) patients with upper and lower urological abnormalities. Material & Method:A retrospective study of case records from year 2009-2012 of SIRS patients with urological abnormalities at Saiful Anwar General Hospital (SAGH) Malang was carried out. The data were collected from the Medical Record Division in SAGH Malang. SIRS was clinicaly diagnosed based on medical history, physical examination and laboratory findings. SIRS without urological abnormalities were excluded from the analysis. The FGSI, which was developed to assign a numerical score that describes the severity of disease, was used in our study. This index presents patients vital signs (temperature, heart and respiratory rates) and metabolic parameters (sodium, potassium, creatinine, and bicarbonate levels, hematocrit, and white blood cell count). Patients with SIRS and urological abnormalities were divided according to upper tract and lower tract urological abnormalities. Total FGSI score was classified as mild (0-8), moderate (9-17), severe (> 17). The data were assessed according to whether the patient survived or died.Results:75 of the 203 evaluated patients died. From those 75 patients, 67% were male and 33% were female, 75% with upper urological abnormalities and 25% with lower abnormalities (p < 0,05). From those 203 patients; the results were analyzed with binary logistical regression and Spearman correlation analysis using SPSS 15 softwarewith 95% confidence interval (CI). There is significant relationship between FGSI and outcome of the patient with upper urological abnormalities and lower urological abnormalities, with correlation coefficient more high in relationship between FGSI and outcome of the patient with upper urological abnormalities (0,4 vs 0,1). Conclusion: FGSI is simple and objective outcome predictor to differentiate survival between SIRS patients with upper urological abnormalities and lower urological abnormalities. There is a significant difference in outcome between SIRS patient with upper urological abnormalities and lower urological abnormalities even with same level of FGSI score.Keywords: Fournier’s gangrene severity index, systemic inflammatory response syndrome, upper urological abnormalities, lower urological abnormalities, outcome predictor.

Split-thickness skin grafting: A modest technique for scrotal reconstruction in patients of Fournier’s gangrene

2019 ◽  
Vol 15 (1) ◽  
pp. 9
Author(s):  
RajeshK Maurya ◽  
Imran Ahmad ◽  
MohammedF Khurram ◽  
Brajesh Pathak ◽  
AliA Mahmud ◽  
...  
Keyword(s):  
Skin Grafting ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Scrotal Reconstruction

Factors affecting length of stay in Fournier’s gangrene: a retrospective analysis of 10 years’ data

2020 ◽  
Author(s):  
Mithat Eksi ◽  
Yusuf Arikan ◽  
Abdulmuttalip Simsek ◽  
Osman Ozdemir ◽  
Serdar Karadag ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Severity Index ◽  
Mortality Rates ◽  
Fournier’S Gangrene ◽  
Index Score ◽  
Fournier's Gangrene ◽  
Wound Therapy ◽  
Severity Index Score

Abstract Background We aimed to investigate the parameters that have an effect on the length of stay and mortality rates of patients with Fournier’s gangrene. Material and Methods A retrospective review was performed on 80 patients who presented to the emergency department and underwent emergency debridement with the diagnosis of Fournier’s gangrene between 2008 and 2017. The demographic and clinical characteristics, length of stay, Fournier’s Gangrene Severity Index score, cystostomy and colostomy requirement, additional treatment for wound healing and the mortality rates of the patients were evaluated. Results Of the 80 patients included in the study, 65 (81.2 %) were male and 15 (18.7 %) female. The most common comorbidity was diabetes mellitus. The mean time between onset of complaints and admission to hospital was 4.6 ± 2.5 days. As a result of the statistical analyses, it was found that Fournier’s Gangrene Severity Index score, hyperbaric oxygen therapy, negative pressure wound therapy and the presence of sepsis and colostomy were significantly positively correlated with length of stay. Also it was found that the Fournier’s Gangrene Severity Index score, administration of negative pressure wound therapy and the presence of sepsis were correlated with mortality. Conclusion Fournier’s gangrene is a mortal disease and an emergency condition. With the improvements in Fournier’s gangrene disease management, mortality rates are decreasing, but long-term hospital stay has become a new problem. Knowing the values predicting length of stay and mortality rates can allow for patient-based treatment and may be useful in treatment choice.

scholarly journals The evaluation of microbiology and Fournier's gangrene severity index in 27 patients

2009 ◽  
Vol 13 (6) ◽  
pp. e424-e430 ◽  
Author(s):  
Mehmet Uluğ ◽  
Ercan Gedik ◽  
Sadullah Girgin ◽  
Mustafa K. Çelen ◽  
Celal Ayaz
Keyword(s):  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene

scholarly journals Analysis of prognostic factors affecting mortality in Fournier’s gangrene: A study of 72 cases

2015 ◽  
Vol 9 (11-12) ◽  
pp. 800 ◽  
Author(s):  
Mohamed Tarchouli ◽  
Ahmed Bounaim ◽  
Mohamed Essarghini ◽  
Moulay Brahim Ratbi ◽  
Mohamed Said Belhamidi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Mortality Rate ◽  
Patient Survival ◽  
Length Of Hospital Stay ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Predisposing Factor ◽  
Duration Of Symptoms ◽  
Factors Affecting

Introduction: Fournier’s gangrene is a rapidly progressing necrotizing fasciitis of the perineum and genital area associated with a high mortality rate. We presented our experience in managing this entity and identified prognostic factors affecting mortality.Methods: We carried out a retrospective study of 72 patients treated for Fournier’s gangrene at our institution between January 2005 and December 2014. Patients were divided into survivors and nonsurvivors and potential prognostic factors were analyzed.Results: Of the 72 patients, 64 were males (89%) and 8 females (11%), with a mean age of 51 years. The most common predisposing factor was diabetes mellitus (38%). The mortality rate was 17% (12 patients died). Statistically significant differences were not found in age, gender, and predisposing factors, except in heart disease (p = 0.038). Individual laboratory parameters significantly correlating with mortality included hemoglobin (p = 0.023), hematocrit (p = 0.019), serum urea (p = 0.009), creatinine (p = 0.042), and potassium (p = 0.026). Severe sepsis on admission and the extent of affected surface area also predicted higher mortality. Others factors, such as duration of symptoms before admission, number of surgical debridement, diverting colostomy and length of hospital stay, did not show significant differences. The median Fournier’s Gangrene Severity Index (FGSI) was significantly higher in non-survivors (p = 0.002).Conclusion: Fournier’s gangrene is a severe surgical emergency requiring early diagnosis and aggressive therapy. Identification of prognostic factors is essential to establish an optimal treatment and to improve outcome. The FGSI is a simple and valid method for predicting disease severity and patient survival.

scholarly journals 122: The Fournier’s Gangrene Severity Index for Predicting Outcome of the Disease: Is it Useful?

2004 ◽  
Vol 171 (4S) ◽  
pp. 32-32
Author(s):  
Eugene Lin ◽  
Stone Yang ◽  
Hsi-Hsien Hsu ◽  
Yung-Chiong Chow
Keyword(s):  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Predicting Outcome

scholarly journals Emergency management and it’s effect on clinical profile of Fournier’s gangrene in patients presenting at a rural setup

2019 ◽  
Vol 6 (12) ◽  
pp. 4397
Author(s):  
Tausif Kamal Syed ◽  
Dilip K. Apturkar ◽  
K. N. Dandekar
Keyword(s):  
Serum Creatinine ◽  
Emergency Management ◽  
Leucocyte Count ◽  
External Genitalia ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Total Leucocyte Count ◽  
P Value ◽  
Fournier's Gangrene ◽  
Soft Tissue Necrosis

Background: Fournier’s gangrene (FG) is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum, leading to soft-tissue necrosis. Despite antibiotics and aggressive debridement, the mortality rate of FG remains high. This study describes our experiences in the management of FG and identifies prognostic factors.Methods: It is a descriptive prospective study in 71 patients with FG treated at Pravara Rural Medical College and Hospital, Loni, who presented between September 2013 and September 2015.Results: In the present series of 71 patients, 57% were between 50-70 yrs. UTI and alcohol consumption being most common co-morbid conditions and scrotal abscess (53.52%) being the most common presentation. Serum creatinine (p value 0.0008), total leucocyte count at presentation (p value 0.004) had a significant association with duration of recovery. The mean duration of stay was 16.08±3.28 days with a median of 15 days. The Fournier gangrene severity index score calculated was <9 in 59.15% of patients, and >9 in the remaining ≈40% with a mean of 8.309±3.49. A single mortality was recorded during our study.Conclusions: Serum creatinine and total leucocyte count at presentation could play a pivotal role in not only initial emergency management but also as factors for monitoring the progress of treatment.

scholarly journals Predisposition Factors Analysis for Fournier’s Gangrene Defects Closure Complication

2021 ◽  
Vol 5 (1) ◽  
pp. 13
Author(s):  
Bayu Fasi Bermani ◽  
Sitti Rizaliyana ◽  
Ira Handriani
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Medical Records ◽  
Early Recognition ◽  
Severe Disease ◽  
Case Series ◽  
Fournier’S Gangrene ◽  
Defect Closure ◽  
Fournier's Gangrene ◽  
Fournier Gangrene

Background: Fournier’s gangrene is a rare and rapidly progressive, necrotizing fasciitis affecting the external genitalia and perineum. Based on the case series that have been reported, the incidence rate of this case is 88% with mortality rate of 20%-40%. The study aims to share our policy in managing Fournier’s gangrene and identifying risk factors that can affect the outcome of defect closure.Method: The medical records of 10 patients with Fournier’s gangrene who presented at the Dr. Soetomo Hospital Surabaya from January 2017 to December 2018 were reviewed retrospectively. We analyzed characteristics of the patients, risk factors, methods of defect closure, and case outcome. There are 10 Fournier’s gangrene patients at Dr. Soetomo Academic General Hospital from January 2017 to December 2018. We analyzed the patient’s medical records retrospectively on the patient’s characteristics, risk factors, method of closing Fournier’s gangrene defects, and the final outcome of the case.Results: There were ten men enrolled in the study, and the mean age was 49.3 ± 11.51 years. All patients received broad-spectrum antibiotic therapy, and extensive surgical excision. This study found that diabetes mellitus and uncontrolled patient blood sugar levels, statistically there is no effect on failure of defect closure in Fournier gangrene patients, but clinically, the relative risk value shows that blood glucose levels have a risk factor of 6 times. increasing the incidence of failure to close the Fournier gangrene defect.Conclusions: Fournier’s gangrene is still considered a severe disease with fairly high mortality rate. Early recognition of predisposition factors associated with invasive and aggressive treatment options is very important in efforts to to reduce morbidity.

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