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Fournier's Gangrene: A Review and Outcome Comparison from 2009 to 2016
Mark Ferretti1, Akhil A Saji1, John Phillips1
1Department of Urology, School of Medicine, New York Medical College, Valhalla, New York.
Advances in Wound Care
|September 13, 2017
Summary
This study on Fournier's gangrene (FG) found that a higher Fournier's Gangrene Severity Index Score (FGSIS) predicted increased mortality and longer hospital stays. Treatment outcomes were comparable to recent literature, showing improvement over historical rates.
Area of Science:
- Urology
- Infectious Diseases
- Surgical Outcomes
Background:
- Fournier's gangrene (FG) is a severe necrotizing infection of the perineum and genitalia.
- Outcomes in FG can be influenced by patient comorbidities, demographics, and treatment strategies.
Purpose of the Study:
- To evaluate the institutional management protocol for Fournier's gangrene.
- To assess the impact of comorbidities, demographics, and treatment on mortality rate (MR) and length of hospital stay (LHS).
Main Methods:
- Retrospective cohort study of 20 FG cases (2009-2016).
- Calculation of Fournier's Gangrene Severity Index Score (FGSIS) for each patient.
- Logistic regression analysis to determine statistical significance.
Main Results:
- The typical FG patient was a hyperglycemic male diabetic in his fifth decade with an additional risk factor.
- An elevated FGSIS was predictive of increased MR and LHS (>25 days) (p=0.0194).
- Average LHS was 32 days; 22 days with hyperbaric oxygen therapy vs. 40 days with tangential hydrosurgery. Overall MR was 15%.
Conclusions:
- Institutional FG management outcomes are comparable to current literature, significantly improving from historical MRs of 50-60%.
- This study contributes to understanding the use of tangential hydrosurgery in FG management.
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