Fournier's gangrene: diagnostic approach and therapeutic challenge
| Autor: | Xeropotamos, N. S., Nousias, V. E., Kappas, A. M. |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2002 |
| Předmět: |
Adult
Aged 80 and over Male Surgical Procedures Operative/*methods Adolescent Greece Debridement/methods Fournier Gangrene/*diagnosis/mortality/*surgery Middle Aged Perineum Risk Assessment Severity of Illness Index Survival Rate Treatment Outcome Scrotum Humans Female Genital Diseases Male/diagnosis/surgery Aged Follow-Up Studies Retrospective Studies |
| Popis: | OBJECTIVE: To identify the prognostic variables and to assess the role of aggressive management in patients with Fournier's gangrene. DESIGN: Retrospective study. SETTING: University hospital, Greece. SUBJECTS: 11 patients (9 men and 2 women) with Fournier's gangrene admitted between April 1986 and December 2000. INTERVENTIONS: Early aggressive debridements. MAIN OUTCOME MEASURES: Postoperative course, hospital stay, outcome, morbidity, and mortality. RESULTS: The mean age was 65 years (range 17-90) and the mean (SD) duration of hospital stay was 35 (8) days (range 8-62). The aetiology was identified in 8 patients and idiopathic in 3. Predisposing factors (diabetes, n = 4; heart failure, agranulocytosis, and alcohol misuse, n = 1 each) were identified in 6 patients. All patients except one had raised serum glucose concentrations and low serum albumin values. On admission the white cell count was >15 x 10(9)/L in 10, serum sodium 150 mg/L was found in all patients. 3/9 male patients required partial excision of the scrotum. Temporary faecal diversion was done for 3 patients. A mean of 3 aggressive repeated debridements (range: 3-6) were required. Nine patients survived and two patients died. CONCLUSION: Rapid and accurate diagnosis remains the key to achieving a successful outcome. Abnormal laboratory variables on admission may suggest the diagnosis. Early, repeated, aggressive debridement is essential for a successful outcome. Eur J Surg |
| Databáze: | OpenAIRE |
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