Cakmak Atil, Genç Volkan, Akyol Cihangir, Kayaoğlu H Ayhan, Hazinedaroğlu Selçuk M
Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey.
Adv Ther. 2008 Oct;25(10):1065-74. doi: 10.1007/s12325-008-0103-1.
Fournier's gangrene was originally described as scrotal gangrene in young males. Today, it is generally accepted as synergistic necrotizing fasciitis of perineal, genital, or perianal regions, and the epidemiologic data have changed. However, there are still limited data about females due to the lack of female patients, even in large case series.
A retrospective review of the medical records of all patients who received surgery for emergency conditions over the past 22 years was performed to identify patients with Fournier's gangrene. Data from these patients were then reviewed to determine the age, gender, etiology, causative bacteria, predisposing factors, treatment modalities, length of hospital stay, and morbidity and mortality rates associated with Fournier's gangrene. Data were evaluated using multivariate analyses.
Sixty-five patients (20 female) were identified with the diagnosis of Fournier's gangrene. The mean age was 50.8 years. The most common etiology was hemorrhoidectomy in male and perianal abscess in female patients. The most commonly isolated microorganism in both male and female patients was Escherichia coli. Twenty-nine patients had diabetes mellitus, which was the most common predisposing factor. Mean hospitalization time was 24.4 days and the overall mortality was 27.70%.
Fournier's gangrene is still an important disease with high mortality rates in spite of the developments in intensive care units and new-generation antibiotics. It seems that there are no major differences between male and female patients in the characteristics of the condition.
福尼尔坏疽最初被描述为年轻男性的阴囊坏疽。如今，它被普遍认为是会阴、生殖器或肛周区域的协同性坏死性筋膜炎，且流行病学数据已发生变化。然而，即便在大型病例系列研究中，由于女性患者数量不足，关于女性患者的数据仍然有限。
对过去22年中因急诊接受手术的所有患者的病历进行回顾性研究，以确定福尼尔坏疽患者。然后对这些患者的数据进行审查，以确定年龄、性别、病因、致病细菌、易感因素、治疗方式、住院时间以及与福尼尔坏疽相关的发病率和死亡率。使用多变量分析对数据进行评估。
确诊为福尼尔坏疽的患者有65例（20例女性）。平均年龄为50.8岁。最常见的病因在男性中是痔切除术，在女性中是肛周脓肿。男性和女性患者中最常分离出的微生物都是大肠杆菌。29例患者患有糖尿病，这是最常见的易感因素。平均住院时间为24.4天，总死亡率为27.70%。
尽管重症监护病房和新一代抗生素有所发展，但福尼尔坏疽仍是一种死亡率很高的重要疾病。在该病特征方面，男性和女性患者似乎没有重大差异。
