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Fournier s gangrene, a urologic and surgical emergency: presentation of a multi-institutional experience with 45 cases Koukouras D; Kallidonis P; Panagopoulos C; Al-Aown A; Athanasopoulos A; Rigopoulos C; Fokaefs E; Stolzenburg JU; Perimenis P; Liatsikos EUrol Int 2011[]; 86 (2): 167-72OBJECTIVE: To review multi-institutional, multidisciplinary experience in the management of Fournier's gangrene (FG) in an attempt to identify etiologic parameters as well as to propose methods of efficient management. PATIENTS AND METHODS: Retrospective chart review of 45 patients diagnosed with FG and treated in three departments (general surgery and urology departments) was performed. RESULTS: Average patient age was 50 +/- 15.8 (range 33-81) years. Five female and 40 male patients. Seven patients deceased due to the disease. In 26 and 6 cases, perianal or ischiorectal abscess was present, respectively. These abscesses were extending up to the level of rectovesical/Douglas pouch in 12 cases. Abscesses in the scrotum and perineum were revealed in 10 and 6 cases, respectively. A fistula to the rectum and 8 sinuses to the skin were observed. Colostomy was performed in 25 cases, diverting cystostomy in 17, and orchidectomy in 12 cases. In 18 patients (40%) repeat debridement was deemed necessary. Three patients required more than 3 debridement procedures. Average hospitalization time was 15.7 +/- 11.6 (range 4-40) days. CONCLUSION: FG is a life-threatening form of necrotizing soft tissue infection. The disease is unpredictable and the currently proposed methods for prognosis are promising but still questionable.|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Bacterial Infections/diagnosis[MESH]|Comorbidity[MESH]|Debridement[MESH]|Fasciitis, Necrotizing/diagnosis/surgery[MESH]|Female[MESH]|Fournier Gangrene/*diagnosis/*surgery[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Retrospective Studies[MESH]|Soft Tissue Infections/diagnosis[MESH]|Treatment Outcome[MESH]|Urology/methods[MESH]|Wound Healing[MESH] |
