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Fournier Gangrene Management: Is a Stoma Mandatory?

Margarida Dupont1, Clara Leal1, Nadia Tenreiro2

  • 1General Surgery, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PRT.

Cureus
|June 28, 2023
PubMed

Insights

Fournier gangrene is a severe, rapidly progressing infection of the genital region, often affecting immunocompromised individuals. Prompt diagnosis and treatment, including surgery and antibiotics, are crucial to prevent fatal septic shock.

Area of Science:

  • Surgical Emergency
  • Infectious Diseases
  • Wound Management

Background:

  • Fournier gangrene is a rare, life-threatening condition.
  • Characterized by rapid polymicrobial infection of the perineal, genital, or perianal areas.
  • Primarily affects males and immunocompromised individuals, including those with diabetes, alcoholism, or HIV.

Observation:

  • Rapid tissue destruction and systemic toxicity are key features.
  • Delayed diagnosis significantly increases mortality risk.
  • Progression to septic shock is a common complication.

Findings:

  • Effective treatment requires a multi-modal approach.
  • Surgical intervention is often necessary.
  • Broad-spectrum antibiotics, fecal diversion, and negative pressure wound therapy (NPWT) are standard treatments.

Implications:

  • Early recognition and intervention are critical for patient survival.
  • Understanding risk factors aids in identifying susceptible populations.
  • Multidisciplinary management improves outcomes for Fournier gangrene patients.
Keywords:
fournier gangrenenecrotizing fasciitisnegative pressure wound therapystomasurgical debridement

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