General Surgery, Jilin University Second Hospital, No 218 ZiQiang Street, Changchun, 130000, China.
Department of Pediatrics, Jilin University First Hospital, No 71 Xinmin Street, Changchun, China.
BMC Surg. 2020 Oct 30;20(1):259. doi: 10.1186/s12893-020-00916-3.
To describe the clinical characteristics and management for Fournier's gangrene. Experience summary and literature references are provided for future treatment improvement.
We retrospectively reviewed the cases diagnosed with Fournier's gangrene in our department from June 2016 to June 2019. Clinical data, including manifestation, diagnosis, treatment and outcomes for Fournier's gangrene were presented.
There were 12 patients enrolled in this paper, with the average age of 60 years old. It showed a male predominance with male-to-female ratio of 6:1. The average of laboratory risk indicator for necrotizing fasciitis (LRINEC) score was 10.1. Diabetes mellitus was the main predisposing disease. 11 patients received emergency debridement and 1 patient died of sepsis on the 2nd day after admission. The mortality rate was 8.3%. 6 cases developed complications, including sepsis, pneumonia, renal and heart failure. Negative pressure wound therapy (NPWT) was applied in 10 cases, while the rest 1 received normal daily dressing changes because of fecal contamination. Flaps were utilized in 2 patients to cover the defect, including one with advancement flap and one with pudendal-thigh flap, while others received secondary suture, secondary healing, skin graft or combined management. No relapse was observed during the follow-up visits.
Fournier's gangrene is a life-threatening infection that requires early diagnosis and surgery intervention. The predisposing disease, clinical manifestation and LRINEC score should be taken into comprehensive consideration, which is helpful for timely diagnosis. Moreover, further successful treatment depends on the aggressive debridement, broad-spectrum antibiotics therapy, wound management and closure choice.
描述 Fournier 坏疽的临床特征和处理方法。提供经验总结和文献回顾，以期改善未来的治疗方法。
回顾性分析 2016 年 6 月至 2019 年 6 月我院收治的 Fournier 坏疽患者。总结其临床表现、诊断、治疗及预后。
共纳入 12 例患者，平均年龄 60 岁，男女比例为 6:1。实验室危险指数评分（LRINEC）平均为 10.1。糖尿病是主要的易患疾病。11 例患者接受了急诊清创术，1 例患者入院后第 2 天死于脓毒症，死亡率为 8.3%。6 例患者发生并发症，包括脓毒症、肺炎、肾和心力衰竭。10 例患者接受负压伤口治疗（NPWT），1 例因粪便污染接受常规日常换药。2 例患者采用皮瓣覆盖缺损，包括 1 例推进皮瓣，1 例阴部股部皮瓣，其余患者采用二期缝合、二期愈合、植皮或联合治疗。随访期间无复发。
Fournier 坏疽是一种危及生命的感染，需要早期诊断和手术干预。易患疾病、临床表现和 LRINEC 评分应综合考虑，有助于及时诊断。此外，进一步的成功治疗取决于积极的清创、广谱抗生素治疗、伤口管理和闭合方式的选择。
