Our Reconstructive Approaches To the Fournier's Gangrene: a Retrospective Study on 27 Patients

Abstract

The necrotizing fasciitis of the perineum and genitalia, known as Fournier's gangrene, is a rare but life-threatening entity. Treatment includes surgical debridement, parenteral antibiotherapy and reconstruction of the resultant defects. The mortality rate is recently still between 15 to 50 percent. In this study, 27 patients managed for Fournier's gangrene were evaluated retrospectively. The ages were ranged from 18 to 81 years old, and all patients but one were male. The resultant defects following the debridement and antibiotherapy were covered using split thickness skin grafts which were utilized with/without primary closure or flaps in 17 patients, thigh flaps in 8, and groin flaps in 4. Primary closure was applied in 5 patients. No male patient underwent orchiectomy. The mean follow up time was 7.7 months. 3 patients (11.1 %) was died postoperatively. No recurrence was occurred. Partial flap necrosis and wound dehiscence were encountered in one each patient who had been reconstructed with thigh flaps, while partial graft failure was ocurred in one. All three complications were secondary healed by means of the conservative methods. All patients were gained normal daily activities and sexual functions postoperatively. It is possible to decrease the mortality rates via early and agressive multidisciplinary approaches; to obtain acceptable aesthetic and functional outcomes by appropriate reconstructive procedures; and to enhance the life standards of the patients in Fournier's gangrene. Recently plastic surgery has gained an important role, because a good reconstruction directly affects the success rate of the treatment.