Al-Meshaan M, Abdul Hamid M, Quider T, Al-Sairafi A, Dham R
Department of Urology, Al Sabah Hospital, State of Kuwait.
Ann Burns Fire Disasters. 2008 Mar 31;21(1):20-2.
Objectives. Fournier's gangrene (FG), though rare, is a life-threatening extensive fulminant infection of the genitals, perineum, or abdominal wall caused by a mixture of aerobic and anaerobic micro-organisms. Early and aggressive surgical debridement of the necrotic tissue and complete antibiotic coverage are the gold standards in treating FG. The purpose of our study was to assess the role of MEBO (moist exposed burn ointment) in topical treatment of the wound secondary to surgical debridement. Methods. Eleven patients (age range, 40-75 yr; mean, 55 yr) were admitted to the clinical facilities of the Department of Urology at Al Sabah Hospital, Kuwait, suffering from Fournier's gangrene, in the 31-month period between January 2004 and July 2006. All these patients were treated with broad-spectrum triple antimicrobial therapy as well as extensive debridement of necrotic tissue. The resultant wounds were treated with MEBO in six randomly selected patients and with a placebo in the remaining five patients. Results. The duration of hospital stay was reduced by 41.7% in the MEBO-treated group (30.0 vs 51.5 days) and pain control of pain was faster, which could be attributed to the faster control of infection and wound healing in this group. Conclusion. A combination of appropriate antibiotic coverage and aggressive surgical therapy is mandatory for the treatment of FG. MEBO promotes the healing of the resulting, quite extensive wound, reducing pain and controlling infection. It is a also a cost-effective therapy as it accelerates healing and reduces hospital stay by 41.7%.
目的。福尼尔坏疽(FG)虽罕见,但却是一种由需氧菌和厌氧菌混合感染引起的、危及生命的生殖器、会阴或腹壁广泛性暴发性感染。早期积极手术清创坏死组织并给予全程抗生素覆盖是治疗FG的金标准。本研究的目的是评估湿润烧伤膏(MEBO)在手术清创后伤口局部治疗中的作用。方法。在2004年1月至2006年7月的31个月期间,科威特萨巴赫医院泌尿外科临床收治了11例患有福尼尔坏疽的患者(年龄范围40 - 75岁,平均55岁)。所有这些患者均接受了广谱三联抗菌治疗以及广泛的坏死组织清创术。随机选择6例患者,其清创后的伤口用MEBO治疗,其余5例患者用安慰剂治疗。结果。MEBO治疗组的住院时间缩短了41.7%(30.0天对51.5天),且疼痛控制更快,这可归因于该组感染控制和伤口愈合更快。结论。治疗FG必须联合适当的抗生素覆盖和积极的手术治疗。MEBO可促进清创后相当大面积伤口的愈合,减轻疼痛并控制感染。它也是一种具有成本效益的治疗方法,因为它加速了愈合并使住院时间缩短了41.7%。