Fournier's gangrene: Seven years of experience in the emergencies service of visceral surgery at Ibn Rochd University Hospital Center. (November 2021)

• Record Type: Journal Article
• Authors: Bensardi, F.Z.; Hajri, A.; Kabura, Sylvestre; Bouali, M.; El Bakouri, A.; El Hattabi, K.; Fadil, A.
• Is Part Of: Annals of medicine and surgery. Volume 71(2021)
• Publication Date: 2021-11
• Subjects: Fournier's gangrene -- Cleanliness stoma -- Antibiotic therapy -- Necrosectomy; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102821
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: This work aims to describe and discuss the epidemiological, clinical, therapeutic and evolution of Fournier's gangrene. Materials and methods: Case series with retrospective data collection of patients treated for Fournier's gangrene between January 2010 and March 2017. The main etiologies, risk factors, postoperative complications outcomes and long term follow up results were analyzed. Results: Eight four (84) patients were recruited. The average age of our patients was 49 years (with limits of 20–76), the male gender dominates our series (83.33%) with a sex ratio of 5 M/1W, the most frequently found risk factor was diabetes mellitus (37%). The most common etiology was anal abscesses (32%). The average time to consultation was 8 days (limits ranges from 3 to 30 days). All patients were admitted at a necrosis stage (100%). Anemia was identified in 85% of cases. The low platelets were noticed in 44.03% of cases. Hypoalbuminemia was found in 93% of cases. All patients (100%) benefited resuscitation initially and antibiotic therapy on their admission. They received emergency surgical debridement with a cleansing stoma. The average length of hospital stay was 13 days and complications occurred in 33% of cases. The mortality rate was 7.14%. Conclusion: Fournier's gangrene is a medico-surgical emergency with a high morbidity and mortality rate. Early diagnosis as well as antibiotic therapy and the quality of debridement save the patients. Highlights: Fournier's gangrene is a rare but severe disease. The diagnosis and treatment delay and lesions extension increase mortality. The treatment is multidisciplinary. Early diagnosis and treatment improve prognosis. Tobacco intoxication is suspected to be risk factor.