Complex treatment for Fournier’s gangrene (case report)

Complex treatment for Fournier’s gangrene (case report)

A.I. Anikin, O.A. Dedenkov, A.M. Skvortsov 

Clinical City Hospital No. 17, Moscow 

Fournier’s gangrene (FG) is a type of necrotizing soft tissue infection manifested by rap-idly progressive necrosis of the scrotum, penis, and perineum. This disease is quite rare, but since its prognosis largely depends on the timing of medical care and the delay in surgical treatment is accompanied by a high mortality rate, reaching 90%, due to the development of septic shock and related complications, it is very relevant. The authors describe a successful treatment of FG complicated by extensive phlegmon of the perineum, glutes, and anterior abdominal wall and sepsis to address an algorithm of complex treatment for this condition. This complex management strategy, which included active surgical tactics and intensive care unit procedures, helped relieve the purulent necrotic process and (later) performed skin grafting of wound defects to achieve recovery. To arrest necrosis, diverting sig-moid colostomy and cystostomy were performed. Meanwhile, these manipulations are performed quite rarely in these patients. Therefore, a complex treatment approach that includes active surgi-cal tactics followed by early skin-plastic interventions and intensive care unit procedures with extracorporeal detoxification, early diagnosis, and surgery is required to improve the treatment outcomes of complicated FG. This algorithm prevents purulent necrotic process and reduces mortality and treatment time for this condition in most patients.

Keywords: Fournier’s gangrene, necrotic soft tissue infection, wound sepsis, treatment, complications, skin grafting.

For citation: Anikin A.I., Dedenkov O.A., Skvortsov A.M. Complex treatment for Fournier’s gangrene (case report). RMJ. 2023;8:36–39.