Kopechek Kyle J, Patel Hiren V, Koch George E
Department of Urology, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Suite 3117, Columbus, OH, 43212, USA.
Department of Urology, The University of Washington, Seattle, WA, USA.
Curr Urol Rep. 2025 Jun 2;26(1):47. doi: 10.1007/s11934-025-01275-3.
This review explores new evidence in Fournier's Gangrene management, emphasizing survivorship. We highlight the shift toward skin-sparing debridement techniques, new reconstructive strategies, and highlight limited evidence on outcomes. Additionally, we examine recent evidence on diagnosis, antimicrobial therapy, adjunctive treatments, and post-operative wound care.
New evidence supports the feasibility of skin-sparing debridement, reducing the need for extensive reconstruction while improving primary closure rates and lowering healthcare costs. Advances in reconstructive techniques accelerate wound healing and shorten hospital stays. Optimized wound management-integrating antimicrobial solutions, negative pressure therapy, and targeted antibiotics-continues to improve recovery while minimizing morbidity and mortality. Modern Fournier's management prioritizes early recognition, tissue preservation, and early genital reconstruction. Despite advancements, gaps remain in early diagnosis and long-term outcomes after the index admission. Further research on post-reconstruction recovery is essential to refine treatment protocols and determine quality of life for affected patients.
本综述探讨了福尼尔坏疽治疗方面的新证据,重点关注生存率。我们强调了向保留皮肤清创技术的转变、新的重建策略,并突出了关于治疗结果的有限证据。此外,我们研究了近期关于诊断、抗菌治疗、辅助治疗和术后伤口护理的证据。
新证据支持保留皮肤清创的可行性,减少了广泛重建的需求,同时提高了一期缝合率并降低了医疗成本。重建技术的进步加速了伤口愈合并缩短了住院时间。优化的伤口管理——整合抗菌溶液、负压治疗和靶向抗生素——在将发病率和死亡率降至最低的同时,持续改善恢复情况。现代福尼尔坏疽治疗将早期识别、组织保留和早期生殖器重建作为优先事项。尽管取得了进展,但在初次入院后的早期诊断和长期结果方面仍存在差距。对重建后恢复情况的进一步研究对于完善治疗方案和确定受影响患者的生活质量至关重要。