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RGUHS Nat. J. Pub. Heal. Sci Vol: 14  Issue: 2 eISSN:  pISSN

Original Article

Prognostic factors and management of Fournier’s Gangrene

Kappikeri VS 1, Vinayak Ingalalli 2, Dharmaprakash N K3

1Professor, 2Post-Graduate, 3Post-Graduate, Department of Surgery, M.R.Medical College, Kalaburagi. 

 

Corresponding author:

Dr. V. S. Kappikeri Prof., Dept. of Surgery Basaveshwara teaching and General Hospital, Kalaburagi - 585105 vijaykapps@yahoo.co.in

Year: 2016, Volume: 6, Issue: 1, Page no. 3-8,
Views: 515, Downloads: 2
Licensing Information:
CC BY NC 4.0 ICON
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0.
Abstract

Background: Fournier's gangrene is a fatal necrotising fasciitis of the perineal region which requires aggressive medical or prompt surgical treatment.

Aim: To study risk and predisposing factors of Fournier's gangrene along with the clinical course and management techniques, and to calculate predictive values of Fournier's gangrene and severity index score (FGSI).

Materials & methods: In a prospective case review between July 2012 to June 2015, predisposing factors, clinical course and FGSI score for all cases of Fournier;s gangrene was evaluated.

Results: Commonest affected age group was 50-60 years. The disease more commonly affected in lower socio-economic group. Diabetes and alcoholism were significantly associated with the disease and association of co-morbidities gravely influenced the prognosis. Average time before referral for treatment was 3days in the survival group and 8.5 days in the non-survival group. FGSI ˂7 had a better outcome, however FGSI˃9 had high mortality rate.

Conclusion: FGSI is an effective score for mortality assessment with a high predictive value. Early detection of patients, adequate surgical debridement and proper antibiotic cover yields good results.

<p><strong>Background: </strong>Fournier's gangrene is a fatal necrotising fasciitis of the perineal region which requires aggressive medical or prompt surgical treatment.</p> <p><strong>Aim: </strong>To study risk and predisposing factors of Fournier's gangrene along with the clinical course and management techniques, and to calculate predictive values of Fournier's gangrene and severity index score (FGSI).</p> <p><strong>Materials &amp; methods: </strong>In a prospective case review between July 2012 to June 2015, predisposing factors, clinical course and FGSI score for all cases of Fournier;s gangrene was evaluated.</p> <p><strong>Results:</strong> Commonest affected age group was 50-60 years. The disease more commonly affected in lower socio-economic group. Diabetes and alcoholism were significantly associated with the disease and association of co-morbidities gravely influenced the prognosis. Average time before referral for treatment was 3days in the survival group and 8.5 days in the non-survival group. FGSI ˂7 had a better outcome, however FGSI˃9 had high mortality rate.</p> <p><strong>Conclusion: </strong>FGSI is an effective score for mortality assessment with a high predictive value. Early detection of patients, adequate surgical debridement and proper antibiotic cover yields good results.</p>
Keywords
Fournier's gangrene, necrotising fasciitis, secondary suturing , split skin grafting and orchidectomy
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