Fournier’s gangrene is an acute, rapidly progressive, and potentially fatal, infective necrotizing fasciitis affecting the external genitalia, perineal or perianal. Penis and scrotum – Fournier gangrene. First documented in by Professor Jean Alfred Fournier (Whonamedit: Fournier Gangrene. Fournier gangrene is a rapidly progressing necrotizing fasciitis involving the perineal, perianal, or genital regions and constitutes a true surgical emergency with.
|Published (Last):||18 September 2008|
|PDF File Size:||4.59 Mb|
|ePub File Size:||18.6 Mb|
|Price:||Free* [*Free Regsitration Required]|
General Discussion Fournier gangrene is an acute necrotic infection of the scrotum; penis; or perineum. Comparisons may be useful for a gagnrena diagnosis. It was paradoxically observed in both studies that mortality was higher in the advanced countries of America, Canada, and Europe than in the underdeveloped countries [ 3 ].
Click here for information on linking to our website or using our content or images. Recently the use of prefabricated gracilis myocutaneous flap for long segment urethral reconstruction has been advocated [ 54 ]. It can also result from infections caused by Group A Streptococcus bacteria and Staphlococcus aureus and Vibrio vulnificus. Information on current clinical trials is posted on the Internet at www.
Fournier’s Gangrene: Current Practices
Open in a separate window. The underlying cause of the Fournier gangrene, such as a perianal abscess, a fistulous tract, or an intraabdominal or retroperitoneal infectious process, may also be demonstrated at CT. According to Wong et al. Most authorities believe the polymicrobial nature of Fournier gangrene is necessary to create the synergy of enzyme production that promotes rapid multiplication and spread of the infection [ 7 ].
Paty R, Smith AD. Although the diagnosis of Fournier gangrene is most commonly made clinically, laboratory studies are required in early setting and also for risk stratification and prediction of mortality.
Related Disorders Symptoms of the following disorders can be similar to those of Fournier gangrene. This disease is commonly found in conjunction with other disorders comorbidityespecially those that weaken the immune system. Last Update November 12, In a review of cases from to worldwide, reported in the English literature, the mortality rate was 16 per cent.
Split thickness skin graft seems to be the treatment of choice in treating perineal and scrotal skin defects.
Fournier’s Gangrene: Current Practices
Patients with a large and deep perineal defect often need this technique to eliminate the dead space. Male diseases of the pelvis and genitals N40—N51— Increased calcium in serum may be due to renal failure, bacteriemia, or use of parenteral nutrition. There has been an increase in number of cases in recent times.
The incidence of this type ganggena hydrocele is higher in older men. Support Center Support Center. Images hosted on other servers: Some cases continue to be of unknown cause idiopathic.
Penile fascia with severe inflammation neutrophilsbacteria and necrotic tissue Thrombosis of small vessels obliterative endarteritis Deep erectile tissue usually remains unaffected. Ultimately, an obliterative endarteritis develops, and the ensuing cutaneous and subcutaneous vascular necrosis leads to localized ischemia and further bacterial proliferation. Fournier gangrene is a urological emergency requiring intravenous antibiotics and debridement surgical removal of necrotic dead tissue.
About one per 62, males are affected per year. West J Emerg Med. Topical Therapy There have been reports of use of honey to aid wound healing. Various workers have used different techniques to provide skin cover including transplantation of testes, free skin grafts, axial groin flaps, and myocutaneous flaps.
Accessed December 31st, Initial gangrean of Fournier gangrene include swelling or sudden pain in the scrotumfever, pallor, and generalized weakness. Pelvic congestion syndrome Pelvic inflammatory disease. Because the infection progresses rapidly, the early stage with lack of subcutaneous emphysema is brief and is rarely fougnier at CT [ 36 ].
Classically Triple therapy is usually recommended.
Scrotal involvement was found in Adnexa Ovary Endometriosis of ovary Female infertility Anovulation Poor ovarian reserve Mittelschmerz Oophoritis Ovarian apoplexy Ovarian cyst Corpus luteum cyst Follicular cyst of ovary Theca lutein cyst Ovarian hyperstimulation syndrome Ovarian torsion. The rationale for rectal diversion includes a decrease in the number of germs in perineal region and improved wound healing.
British Journal of Plastic Surgery. Gangreja Espanoles de Urologia. The presentation may also be insidious as opposed to the classical sudden onset presentation. Urethral reconstruction through a variety of methods including anterolateral thigh flaps, radial artery forearm free flap, and other simple skin and mucosal flaps were being done.
InBaurienne originally described an idiopathic, rapidly progressive soft-tissue necrotizing process that led to gangrene of the male genitalia.
Another alternative is the pudendal thigh flap.