Fournier's gangrene: an approach to its management

Treatment of Fournier's gangrene (necrotizing fasciitis of the male genitalia) traditionally has involved extensive débridement in concert with broad-spectrum antibiotic administration. However, our management of 4 patients with Fournier's gangrene indicates that limited débridement with placement of through-and-through drains may provide a good result, with far less tissue loss. After surgery and prompt, individualized antibiotic treatment the patients showed rapid improvement in their over-all condition with a brisk defervescence and normalization of leukocytosis. Granulation of the wounds progressed rapidly without secondary infection. In 2 of the 4 patients some skin grafting was required but the areas involved were quite small.