Abstract
IntroductionFournier's gangrene (FG) is a fulminant necrotizing fasciitis of the perineum and genitalia. The objective of this study was to study the etiology and microbiology associated with FG and to study the debridement and reconstructive procedures required in these patients.MethodsThis was a prospective follow up study conducted from September 2011 to November 2012 at Coimbatore medical college hospital, Coimbatore, India. Patients presenting to the outpatient department and emergency department with the clinical diagnosis of FG were included in the study.ResultsA total of 34 patients were studied in the study period. The mean age of presentation in years was 50±11.13. The male to female ratio was 33:1. The source of the infection was most commonly anorectal. Diabetes mellitus was the most common co morbid factor associated. Most commonly the disease was polymicrobial with escherichia coli being the commonest grown organism. The average number of wound debridement required was 2.9±1.42. Primary closure of the scrotal skin defect was the most common reconstructive procedure performed. Mortality associated with the disease in our series was 11.8%.ConclusionAlthough FG is a relatively rare disease, it is still prevalent in Indian population. Incidence of FG in HIV patients is high, even though it is not the commonest of the co morbid condition. The mortality can be kept to minimal with aggressive medical and surgical management. Extensive raw area following the infection and wound debridement can be managed by simple reconstructive procedures with good outcome.
Highlights
Fournier's gangrene (FG) is a fulminant necrotizing fasciitis of the perineum and genitalia
Patients presenting with necrotizing fasciitis of the genitalia and perineum were included and patients with only perianal/ischiorectal abscess were excluded from the study
Diabetes mellitus (38.2%) was the most common co morbid factor present followed by chronic alcoholism (20.6%), HIV (17.6%), chronic renal failure (8.9%), chicken pox (2.9%) and pulmonary tuberculosis (2.9%) (Table 2)
Summary
Fournier's gangrene (FG) is a fulminant necrotizing fasciitis of the perineum and genitalia. It is a rapidly progressing, polymicrobial necrotizing fasciitis of the perineal, perianal, and genital regions, with a mortality rate ranging from 15% to 50% [1, 2] It is a relatively rare disease which is more common in poor socioeconomic strata of population. The literature regarding simple reconstructive procedures for the management of raw area following debridement of FG is limited In this series we intend to study and analyze the etiology and microbiology of FG in the South Indian population. We intend to study the feasibility of simple reconstructive procedures for the management of raw area due to the disease and debridement in the study population
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