Huayllani Maria T, Cheema Amandip S, McGuire Matthew J, Janis Jeffrey E
Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Department of Urology, Loyola University Medical Center, Maywood, Ill.
Plast Reconstr Surg Glob Open. 2022 Mar 14;10(3):e4191. doi: 10.1097/GOX.0000000000004191. eCollection 2022 Mar.
Fournier's gangrene is a fulminant disease. If diagnosed and treated early, mortality can be minimized, but morbidity can still be important with extensive soft tissue defects affecting form and function. We aimed to perform a comprehensive review and provide the current evidenced-based management to treat this condition.
A review was conducted to identify relevant published articles involving Fournier's gangrene in PubMed on September 8, 2021. Search keywords included "{[(Fournier's gangrene) AND (reconstruction)] OR [Fournier's gangrene]} AND [(repair) OR (management)]."
A total of 108 articles met the inclusion criteria. The comorbidities most frequently associated included diabetes, hypertension, and obesity. Pillars of treatment involve urgent debridement, fluid resuscitation, IV antibiotics, and reconstruction. Several variables must be considered, including time to debridement, duration of antibiotics, debridement, and an individualized approach to choose a reconstructive option. Skin grafts and multiple types of flaps are commonly used for reconstruction.
Treatment of Fournier's gangrene should be initiated as early as possible. Surgeons' expertise, patient preference, and resources available are essential factors that should direct the election of reconstruction.
福尼尔坏疽是一种暴发性疾病。如果早期诊断和治疗，死亡率可降至最低，但由于广泛的软组织缺损影响形态和功能，发病率仍可能较高。我们旨在进行全面综述，并提供当前基于证据的治疗方法。
于2021年9月8日在PubMed上进行综述，以识别涉及福尼尔坏疽的相关已发表文章。搜索关键词包括“{[（福尼尔坏疽）AND（重建）]OR[福尼尔坏疽]}AND[（修复）OR（治疗）]”。
共有108篇文章符合纳入标准。最常伴发的合并症包括糖尿病、高血压和肥胖。治疗的关键包括紧急清创、液体复苏、静脉使用抗生素和重建。必须考虑几个变量，包括清创时间、抗生素使用时长、清创以及选择重建方案的个体化方法。皮肤移植和多种皮瓣常用于重建。
福尼尔坏疽的治疗应尽早开始。外科医生的专业技能、患者偏好和可用资源是指导重建方案选择的重要因素。
