Kuchinka Jakub, Matykiewicz Jarosław, Wawrzycka Iwona, Kot Marta, Karcz Włodzimierz, Głuszek Stanisław
General, Oncological and Endocrine Surgery Clinic, Provincial Hospital in Kielce, Poland.
Faculty of Medicine and Health Sciences, Jan Kochanowski University in Kielce, Department of Surgery and Surgical Nursing with a Laboratory of Scientific Research and a Laboratory of Genetics, Kielce, Poland.
Pol Przegl Chir. 2019 Nov 21;93(1):55-60. doi: 10.5604/01.3001.0013.5894.
Fournier gangrene (FG) is life - threatening condition, defined as the necrotizing fascitis of perineum and can spread to the adjacent areas. It is rare disease and infection is caused by mixed bacterial flora, seldom by fungal infection. Risk factors are: male sex, diabetes, hypertension, malignant neoplasms, alcoholism, immunospression.
The analysis of four group patients treateted for Fournier gangrene was made about diagnostic and therapeutic process, assessment of prognosis based on Fournier's Gangrene Severity Index).
All patients were males. Average age at the moment of diagnosis was 60 years. All of them had comorbidities resulting with the higher risk of susceptibility to FG. Morbitity was 50%, despite of all of patients had less than 9 points in FGSI.
The FG, despite of better diagnostic tools and technological progres remaines the significant clinical issue because of the mortality - 80%. "The golden standard" is surgical excision of necrotic tissues, antibiotics support, equation of fluid, electrolytes and base - acid balance, level of glycemia is very important. The treating results were assessed on the base of FGSI. The significance has the moment of performing the surgical intervention - it is proven, that should be carried out during 24 hours. The hyperbaric oxygen therapy is controversial. Seem to be appropriate if the infection is caused by anaerobic bacteria.
Fournier syndrome is significant clinical issue. Its treatment requires early surgical approach with exicision of necrotic tissues, antibiotics support and treatment of hyperbaric oxygen in some cases.
福尼尔坏疽（FG）是一种危及生命的疾病，定义为会阴部坏死性筋膜炎，可蔓延至邻近区域。它是一种罕见疾病，感染由混合菌群引起，真菌感染较少见。危险因素包括：男性、糖尿病、高血压、恶性肿瘤、酗酒、免疫抑制。
对四组接受福尼尔坏疽治疗的患者进行了诊断和治疗过程分析，并根据福尼尔坏疽严重程度指数评估预后。
所有患者均为男性。诊断时的平均年龄为60岁。他们都有合并症，导致患FG的易感性风险更高。尽管所有患者的福尼尔坏疽严重程度指数（FGSI）均低于9分，但死亡率仍为50%。
尽管有更好的诊断工具和技术进步，但由于死亡率达80%，FG仍然是一个重大的临床问题。“金标准”是手术切除坏死组织、抗生素支持、平衡液体、电解质和酸碱平衡，血糖水平非常重要。根据FGSI评估治疗结果。手术干预的时机很重要——事实证明，应在24小时内进行。高压氧治疗存在争议。如果感染由厌氧菌引起，似乎是合适的。
福尼尔综合征是一个重大的临床问题。其治疗需要早期手术，切除坏死组织，给予抗生素支持，在某些情况下进行高压氧治疗。
