Comparison of two different surgical techniques in the treatment of Fournier’s Gangrene

Abstract

AbstractFournier’s gangrene is a rapidly progressive, fatal, necrotizing fasciitis of the perineum and penoscrotal region which requires rapid intervention. This retrospective study compares the surgical outcomes of the fasciocutaneous flap and the embedding of the testicles into the thigh skin, applied for the reconstruction of penoscrotal defects after surgical debridement due to Fournier’s gangrene, in the light of the literature. A total of 110 patients treated for Fournier’s gangrene at Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Urology, Urology Clinic between 2009 and 2021 were evaluated retrospectively. Among these, 82 patients treated with fasciocutaneous flap and embedding of the testicles into the thigh skin for the reconstruction of penoscrotal defects were included inthe study. For these two wound closure methods, the cases were compared in age, hospital stay after debridement, hospital stay after wound closure, size of the debrided area, and postoperative complication parameters. There was no significant difference between the two groups in terms of age, comorbidity (hypertension, diabetes mellitus, etc.), and hospital stay after debridement. However, the length of hospital stay after wound closure and the size of the debrided area were significantly higher in patients with fasciocutaneous flap compared to the method in which the testis was embedded in the thigh. The fasciocutaneous flap application, which we apply for defects larger than 50% of the scrotum or extending beyond the scrotum, is a method that can be preferred by experienced surgeons for wound closure after Fournier gangrene debridement, considering patient comfort, since it does not create tension and blood supply to the testis is more comfortable. However, it would be more appropriate for the clinician to make a profit-loss calculation due to both the length of the operation and its more complex nature and the prolongation of the hospital stay after wound closure.