Fournier's Gangrene: Our Five-Year Series and the Role of Vacuum-Assisted Closure in the Treatment.

Abstract

Fournier's Gangrene (FG) is the necrotizing fasciitis of the perineal region. To compare the effectiveness of debridement alone and debridement with vacuum-assisted closure in the treatment of Fournier's gangrene. Twenty-two patients operated for FG were analyzed retrospectively. Debridement-only and debridement + VAC treatment groups were compared in terms of age, gender, predisposing factors, comorbid diseases, intensive care unit and hospital stay durations, laboratory results, septic shock, treatment methods, Fournier' gangrene severity index (FGSI) and mortality. The M/F ratio was 13/9. There were 10 and 12 patients in debridement-only and debridement + VAC groups, respectively. Ten patients (45.5%) were admitted to intensive care unit, 8 (36.4%) needed colostomy and 7 (31.9%) developed septic shock, respectively. The mortality rate was 27.3%. There was no significant difference in terms of age, gender, laboratory parameters, number of debridement, length of stay in intensive care unit and hospital, shock duration, and mortality (P > 0.05). The FGSI scores also did not show any difference between the groups which showed that the severity of the disease in both groups are similar. The VAC treatment was found not to provide a statistically significant benefit on mortality. Early and adequate debridement and antibiotic are still the most important factors in the treatment of FG and to reduce mortality.