MP35-08 CLINICAL CHARACTERISTICS ASSOCIATED WITH WOUND CLOSURE IN PATIENTS WITH FOURNIER'S GANGRENE: A SINGLE TERTIARY INSTITUTION EXPERIENCE

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP35)1 Sep 2021MP35-08 CLINICAL CHARACTERISTICS ASSOCIATED WITH WOUND CLOSURE IN PATIENTS WITH FOURNIER'S GANGRENE: A SINGLE TERTIARY INSTITUTION EXPERIENCE Michael Pintauro, Christopher Staniorski, Michelle Yu, Benjamin Davies, Bruce Jacobs, and Paul Rusilko Michael PintauroMichael Pintauro More articles by this author , Christopher StaniorskiChristopher Staniorski More articles by this author , Michelle YuMichelle Yu More articles by this author , Benjamin DaviesBenjamin Davies More articles by this author , Bruce JacobsBruce Jacobs More articles by this author , and Paul RusilkoPaul Rusilko More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002044.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fournier’s gangrene (FG) is a surgical emergency requiring early aggressive debridement of infected tissue. The subsequent defect must then close either via primary or secondary intention, the latter often with adjunct graft or flap to bridge gaps in tissue. To date, no study has analyzed associations between patients with closed and unclosed wounds. We sought to identify factors associated with wound closure during index hospitalization. METHODS: We retrospectively reviewed all cases of FG using the electronic medical records system at a single tertiary care hospital from 2016-2020. All patients who underwent at least one debridement were identified and stratified into wound closure during index hospitalization versus no wound closure. Patients who expired during hospitalization were excluded. We analyzed patient data including age, gender, median body mass index (BMI), diabetes (DM) rate, congestive heart failure (CHF) rate, smoking status, Fournier’s Gangrene Severity Index (FGSI), need for suprapubic tube, median length of stay (LOS), use of vacuum assisted closure (VAC) devices, and median number of surgical operations. RESULTS: A total of 72 patients were identified at our institution with 45 (63%) patients undergoing wound closure (Table 1). The majority of patients were male (76%) and were smokers (58%). There were no significant differences in age, BMI, smoking status, FGSI, DM, LOS, number of operations, and suprapubic tube need. The median [interquartile range] LOS was 16 [13, 33] days and was not different between the two groups. There was a statistically significant association between unclosed wounds and CHF (22.2% vs. 4.4%, p=0.046). As expected, VAC usage was statistically different with 33 (77%) of closed wounds and 25 (93%) of unclosed wounds (p=0.02). CONCLUSIONS: This is the first single-center study directly examine associations between wound closure and patient demographics and hospital course. Our institutional study demonstrated CHF and VAC usage as the statistically significant association with delayed wound closure. Interestingly, there was no difference between number of operations, need for suprapubic tube, FGSI, or LOS - factors which may portend worse disease state - and wound closure rate. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e629-e630 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Pintauro More articles by this author Christopher Staniorski More articles by this author Michelle Yu More articles by this author Benjamin Davies More articles by this author Bruce Jacobs More articles by this author Paul Rusilko More articles by this author Expand All Advertisement Loading ...