[Perineal gangrene: clinical and therapeutic features and prognostic analysis of 35 cases]

The objective of this retrospective study of 35 cases of perineal gangrene was to describe their clinical and therapeutic features and to analyze the prognostic factors of mortality.

From 1997 to 2004, 35 cases (25 men and 10 women, mean age=50.3 years) with perineal gangrene were treated in the "A" surgical department of Charles Nicole Hospital (Tunisia) with a combination of intensive care, antibiotic therapy, extensive excision and drainage, repeated if necessary and colostomy.

The mortality rate was 17.1%. The mean duration of hospitalization was 15.3 (range: 2-64) days. One patient had anal incontinence as sequelae. The colostomy in two patients was closed at the 9(th) and the 13(th) month. Statistical analysis showed that the extent of cellulitis, presence of myonecrosis, occurrence of septic shock need for postoperative mechanical ventilation, and IGSII and FGSIS severity scores differed significantly between patients who survived and those who died.

Perineal gangrene is still a very severe disease. The initial anatomic lesions, the IGSII and FGSIS severity scores and postoperative complications are the main prognostic factors of mortality.