Eltorai I M, Hart G B, Strauss M B, Montroy R, Juler G L
Int Surg. 1986 Jan-Mar;71(1):53-8.
Fournier's gangrene of the external genitals is a complex entity characterized by acute onset, rapid progress to gangrene, toxemia and high mortality rate. The disease may be primary as described by Fournier or secondary with a detectable cause in the colo-rectal area, the lower urogenital tract or in the perineum. The disease may affect healthy young males (originally described by Fournier) or elderly subjects especially with general ill health, cancer, diabetes, liver or renal failure, immunosuppression, etc. The microbiology is as complex as the etiology. The nosiology is likewise complex. Because the mortality is high, it is important to be aggressive in therapy. Triple attack is necessary, viz.: antibiotic coverage for aerobes and anaerobes, general supportive measures and adequate surgical debridement. We, recommend Hyperbaric Oxygen Therapy (HBO) treatment in specialized centers as an adjunctive measure since we had no mortality in the cases we treated. In expert centers, HBO has very few complications which are outweighed by the benefit the patient gets. The one-man chamber is the commonest in use, but for a compromised patient the multiplace may be more appropriate. In the very early stage, HBO may avert gangrene or reduce it. It is important to have a high index of awareness of this disease amongst the medical profession. More work is needed for the more precise definition, classification and management of the complex syndrome of Fournier.
外生殖器福尼尔坏疽是一种复杂的病症，其特点为发病急、迅速发展为坏疽、出现毒血症且死亡率高。该疾病可能如福尼尔所描述的那样是原发性的，也可能是继发性的，继发于结直肠区域、下泌尿生殖道或会阴部位的可查明病因。此病可影响健康的年轻男性（最初由福尼尔描述）或老年患者，尤其是那些身体状况较差、患有癌症、糖尿病、肝或肾衰竭、免疫抑制等疾病的患者。微生物学情况与病因一样复杂。疾病分类学同样复杂。由于死亡率高，积极治疗很重要。需要采取三联疗法，即：针对需氧菌和厌氧菌的抗生素覆盖、一般支持措施以及充分的手术清创。我们建议在专业中心采用高压氧疗法（HBO）作为辅助措施进行治疗，因为我们治疗的病例中没有出现死亡情况。在专家中心，HBO的并发症很少，患者从中获得的益处超过了这些并发症。单人舱是最常用的，但对于病情较重的患者，多人舱可能更合适。在疾病的极早期阶段，HBO可能避免坏疽或减轻其程度。在医疗行业中提高对这种疾病的高度认识很重要。对于更精确地定义、分类和管理福尼尔复杂综合征，还需要开展更多工作。
