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福尼尔坏疽的特征及负压伤口治疗效果评估

Characteristics of Fournier gangrene and evaluation of the effects of negative-pressure wound therapy.

作者信息

He Rui, Li Xiangyan, Xie Kun, Wen Bing, Qi Xin

机构信息

Department of Plastic Surgery and Burn, Peking University First Hospital, Beijing, China.

Department of Anti-Infection, Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China.

出版信息

Front Surg. 2023 Jan 6;9:1075968. doi: 10.3389/fsurg.2022.1075968. eCollection 2022.

DOI:10.3389/fsurg.2022.1075968
PMID:36684293
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9857754/
Abstract

Fournier gangrene (FG) is a life-threatening disease affecting the soft tissues of the genital, perineal, and perianal regions. This retrospective study aimed to summarize the characteristics of FG and evaluate the effects of negative-pressure wound therapy (NPWT). We analyzed clinical data of 36 patients with FG admitted to our department. Thirty-four cases had perianal and external genital infections, and the other two had secondary infection of the urinary fistula after trauma and retroperitoneal abscess, respectively. Monomicrobial, polymicrobial, culture-negative, and fungal infections were identified in 16, 17, 2, and 1 cases, respectively. , and were the most common pathogens. The mortality rate was 8%. Twenty-seven and nine patients were treated with NPWT (group A) and conventional dressing (group B), respectively. The length of stay was 38.0 ± 16.1 and 51.0 ± 17.3 days, number of operations were 3 (3,6) and 13 (4,17), and wound healing times were 39.2 ± 18.1 and 66.5 ± 17.1 days in groups A and B, respectively. Taken together, clinicians should always consider the possibility of perianal or external genital infections progressing to FG in the daily work, especially for patients with diabetes mellitus. , and are the most common causative pathogens, and NPWT is an effective adjuvant therapy for wound management with fewer operations and a shorter wound healing time.

摘要

福尼尔坏疽(FG)是一种危及生命的疾病,影响生殖器、会阴和肛周区域的软组织。本回顾性研究旨在总结FG的特征并评估负压伤口治疗(NPWT)的效果。我们分析了我院收治的36例FG患者的临床资料。34例为肛周和外生殖器感染,另外2例分别为外伤后尿瘘继发感染和腹膜后脓肿。分别在16例、17例、2例和1例中鉴定出单一微生物、多种微生物、培养阴性和真菌感染。 和 是最常见的病原体。死亡率为8%。27例和9例患者分别接受了NPWT治疗(A组)和传统敷料治疗(B组)。A组和B组的住院时间分别为38.0±16.1天和51.0±17.3天,手术次数分别为3次(3,6)和13次(4,17),伤口愈合时间分别为39.2±18.1天和66.5±17.1天。综上所述,临床医生在日常工作中应始终考虑肛周或外生殖器感染进展为FG的可能性,尤其是糖尿病患者。 和 是最常见的致病病原体,NPWT是一种有效的伤口管理辅助治疗方法,手术次数较少,伤口愈合时间较短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747f/9857754/71ac1c520ab0/fsurg-09-1075968-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747f/9857754/71ac1c520ab0/fsurg-09-1075968-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747f/9857754/71ac1c520ab0/fsurg-09-1075968-g001.jpg

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Distinctions between Fournier's gangrene and lower extremity necrotising fasciitis: microbiology and factors affecting mortality.Fournier 坏疽与下肢坏死性筋膜炎的鉴别:微生物学和影响死亡率的因素。
Int J Infect Dis. 2022 Sep;122:222-229. doi: 10.1016/j.ijid.2022.05.040. Epub 2022 May 20.
2
Efficiency of Hyperbaric Oxygen Therapy Combined with Negative-Pressure Wound Therapy in the Treatment Strategy of Fournier's Gangrene -A Retrospective Study.高压氧治疗联合负压伤口疗法在 Fournier 坏疽治疗策略中的疗效 - 一项回顾性研究。
Urol J. 2021 Aug 16;19(4):329-332. doi: 10.22037/uj.v18i.6797.
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Fournier 坏疽死亡率:17 年系统回顾和荟萃分析。
Int J Infect Dis. 2020 Mar;92:218-225. doi: 10.1016/j.ijid.2019.12.030. Epub 2020 Jan 18.
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Fournier's Gangrene and Intravenous Drug Abuse: an Unusual Case Report and Review of The Literature.福尼尔坏疽与静脉药物滥用:一例罕见病例报告及文献综述
Open Med (Wars). 2019 Dec 24;14:694-710. doi: 10.1515/med-2019-0114. eCollection 2019.
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Factors Affecting Mortality in Fournier Gangrene: A Single Center Experience.影响福尼尔坏疽死亡率的因素:单中心经验
Surg Infect (Larchmt). 2019 Jan;20(1):78-82. doi: 10.1089/sur.2018.208. Epub 2018 Nov 7.
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EWMA Document: Negative Pressure Wound Therapy.EWMA文件:负压伤口治疗
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