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[福尼尔坏疽后的重建方法]

[Reconstructive methods after Fournier gangrene].

作者信息

Wallner C, Behr B, Ring A, Mikhail B D, Lehnhardt M, Daigeler A

机构信息

Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, Operatives Referenzzentrum für Gliedmaßentumoren, BG-Universitätsklinikum Bergmannsheil Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland.

出版信息

Urologe A. 2016 Apr;55(4):484-8. doi: 10.1007/s00120-015-4001-2.

Abstract

BACKGROUND

Fournier's gangrene is a variant of the necrotizing fasciitis restricted to the perineal and genital region. It presents as an acute life-threatening disease and demands rapid surgical debridement, resulting in large soft tissue defects. Various reconstructive methods have to be applied to reconstitute functionality and aesthetics. The objective of this work is to identify different reconstructive methods in the literature and compare them to our current concepts for reconstructing defects caused by Fournier gangrene.

METHODS

Analysis of the current literature and our reconstructive methods on Fournier gangrene.

RESULTS

The Fournier gangrene is an emergency requiring rapid, calculated antibiotic treatment and radical surgical debridement. After the acute phase of the disease, appropriate reconstructive methods are indicated. The planning of the reconstruction of the defect depends on many factors, especially functional and aesthetic demands. Scrotal reconstruction requires a higher aesthetic and functional reconstructive degree than perineal cutaneous wounds. In general, thorough wound hygiene, proper pre-operative planning, and careful consideration of the patient's demands are essential for successful reconstruction.

CONCLUSIONS

In the literature, various methods for reconstruction after Fournier gangrene are described. Reconstruction with a flap is required for a good functional result in complex regions as the scrotum and penis, while cutaneous wounds can be managed through skin grafting. Patient compliance and tissue demand are crucial factors in the decision-making process.

摘要

背景

福尼尔坏疽是坏死性筋膜炎的一种变体,局限于会阴和生殖器区域。它表现为一种急性危及生命的疾病,需要迅速进行手术清创,这会导致大面积软组织缺损。必须应用各种重建方法来恢复功能和美观。这项工作的目的是在文献中确定不同的重建方法,并将它们与我们目前用于重建福尼尔坏疽所致缺损的概念进行比较。

方法

分析当前关于福尼尔坏疽的文献以及我们的重建方法。

结果

福尼尔坏疽是一种急症,需要迅速、合理地使用抗生素治疗并进行根治性手术清创。在疾病的急性期过后,需要采用适当的重建方法。缺损重建的规划取决于许多因素,尤其是功能和美观需求。阴囊重建比会阴皮肤伤口需要更高的美学和功能重建程度。一般来说,彻底的伤口清洁、适当的术前规划以及仔细考虑患者的需求对于成功重建至关重要。

结论

文献中描述了福尼尔坏疽后各种重建方法。对于阴囊和阴茎等复杂区域,为获得良好的功能效果需要采用皮瓣重建,而皮肤伤口可通过植皮处理。患者的依从性和组织需求是决策过程中的关键因素。

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