Related Experiment Videos
Fournier's gangrene--Taiwan experience
1Division of Plastic Surgery, Taipei Municipal Chung-Hsiao Hospital, 87, Tung-Teh Road, Nankang, Taipei 115, Taiwan. tuanhsin@ms27.hinet.net
Background:
Synergistic necrotizing fascitis of the scrotum, penis and perianal region was first described by Fournier in 1883. If not recognized early, this infectious process will extend along the fascia plane to the lower abdominal and back regions, causing severe morbidity and even mortality.
Methods:
The records of 8 patients diagnosed of Fournier's gangrene were reviewed between 1988 and 2000. The sex, age, etiology, associated diseases, bacteriological studies and treatments were analyzed.
Results:
The 8 patients were all males, age ranging from 42 to 78 years old, with average 55.1 years. Six patients were due to perianal abscess, one patient was a complication of hemorroidectomy, and one patient had traumatic injury of scrotum. Six patients had poor controlled diabetes mellitus, and there were two patients with cirrhosis of the liver and hepatoma, respectively. Even with aggressive treatments, two patients died; the other 6 recovered completely. The mortality rate was 25%.
Conclusions:
Fournier's gangrene is a not common but life-threatening disease which needs radical debridement and effective antibiotics to control the infection and early reconstruction with skin graft and myocutaneous flaps. Mortality is usually due to delayed diagnosis.