FOURNIER'S GANGRENE (REPORT OF 8 CASES)

Abstract

Fournier's gangrene is defined as a fulminant synergistic necrotizing fasciitis of the perineum and abdominal wall along with scrotum and penis in men and vulva in women. 8 cases of Fournier's gangrene, managed surgically between 1985 to 1993 years in our clinic were presented. The patients consisted of 2 women and 6 men, with an average age of 54.9 years. The cause of the infections were perianal sepsis (3 patients), repair of inguinal hernia (2 patients), Bartholin's abscess (one patient) and urinary infection (one patient). In one patient the cause couldn't be determined exactly. Diabetes mellitus was considered to be a predisposing factor in 3 patients. S.aureus and E. Coli were the most frequent organisms isolated in wound cultures.

Our treatment is based on early recognition, wide debridement of necrotic tissues, frequent local treatment and institution of broad spectrum antibiotherapy. Additionally, 4 diverting colostomies and 2 suprapubic cystostomies were performed. There were two deaths. Four of the 6 living cases underwent several procedures for the reconstruction of the excised zones and in the other two cases the wounds were left for secondary healing.