Fournier’s Gangrene – Management in Rural Tertiary Centre
Fournier’s gangrene is a potentially lethal synergistic necrotizing fascitis of the external genitalia and perineal tissues. Young men are the most commonly impacted, but women and children can also be affected. The mainstay of treatment and a crucial determinant of prognosis is the use of broad-spectrum antibiotics and surgical intervention with serial wound debridement. Rebuilding a soft tissue defect after it has been debrided is a challenging task. The purpose of this study is to assess surgical approaches for repairing soft tissue abnormalities caused by Fournier’s gangrene. gangrene. Methods: All patients with necrotizing fasciitis of the external genitalia and perineum who presented to our hospital, regardless of age or gender, were included in this prospective study. Age, gender, aetiology, predisposing variables, clinical features, defect location, type of bacterial flora, reconstructive treatment, length of hospital stay, post-operative pain, patient satisfaction, and death, if any, were all looked into. The procedure was chosen based on the severity of the deformity, the availability of local tissue, and the preferences of the patient. Reconstructive treatments were performed on 31 individuals. Participants ranged in age from four to seventy-four years old (mean 38.5). The most common symptoms were pain, scrotal enlargement, and fever. The most common cause was urogenital diseases. Ten patients were treated with split-thickness skin grafts, five with secondary suturing, two with unilateral superomedial thigh flaps, four with bilateral superomedial thigh flaps, five with tensor fascia lata flaps, two with medial thigh V-Y advancement flaps, and one with perineal artery flap. Conclusion: Early presentation, early diagnosis, and intervention with debridement and appropriate antibiotics are the pillars of treatment, according to this study. Soft tissue abnormalities created by wound debridement, with the exception of one case, necessitated surgical reconstruction, reducing morbidity, hospital stay, and patients’ return to normal life.
Author (S) Details
Dr. Naveen Narayan
Department of Plastic & Reconstructive Surgery, Adichunchanagiri Institute of Medical Sciences, B. G. Nagara, Karnataka, India.
Dr. Ravi H. Shivaiah
Department of Plastic & Reconstructive Surgery, JSS hospital, Mysore, Karnataka, India.
Dr. Suhas Narayan Swamy Gowda
Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, B. G. Nagara, Karnataka, India.
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