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Fournier’s Gangrene: Management in a Poor Resource Setting

  • Surgery
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Abstract

Fournier’s gangrene is a rapidly progressive necrotizing infection of the external genitalia. We aim to share our clinical experience in the management of this disease. This was a retrospective study with data retrieved from the case note of patients seen with Fournier’s gangrene between January 2013 and April 2019. A total of 23 cases were analysed, who were all men, with a mean age of 47 years. The mean duration before presentation was 8 days. Perianal lesion was the most common aetiological factor occurring in 39% and the most common isolated organism was E. coli. The mean number of debridement was 1.5 while 2 patients required colostomy. The mortality rate was 9% in this study. Despite improvement in clinical care, Fournier’s gangrene remains a potentially fatal condition. Thus, aggressive resuscitation, debridement and judicious antibiotic therapy are required.

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Authors and Affiliations

  1. Department of Surgery, General Hospital, Marina, Lagos, Nigeria

    Odusanya Benjamin Olasunkanmi & Niran Abdulwaid Saliu

  2. Department of Orthopaedics, General Hospital, Marina, Lagos, Nigeria

    Olayinka Abdurraheem Salami

Authors
  1. Odusanya Benjamin Olasunkanmi
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  2. Niran Abdulwaid Saliu
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  3. Olayinka Abdurraheem Salami
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Correspondence to Odusanya Benjamin Olasunkanmi.

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The authors declare that they have no conflict of interest.

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Approval of the ethical committee of General hospital Lagos was obtained. Patient anonymity and confidentiality were maintained at all times.

Informed Consent

Informed consent of patients whose pictures were used in the study was obtained and they were re-assured that no identifying body parts will be shown.

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Appendix

Appendix

PROFORMA: FOURNIER’S GANGRENE

HOSPITAL NUMBER

AGE

GENDER

DURATION BEFORE PRESENTATION

CLINICAL FEATURES

Scrotal pain

Scrotal swelling

Discharge

Discoloration

Exposure of testis

Fever

Pallor

Dehydration

Heart rate

Respiratory rate

Blood pressure

Hypotension

Size of ulcer

Areas affected

scrotum anterior wallscrotum posterior wall perineum ischiorectal fossa penis anterior abdominal wall others

Presence of perianal lesion

Urethral instrumentation

Urethral stricture

Scrotal trauma

Comorbidities:

Diabetes

If yes duration

Immunosuppression

Others state:

INVESTIGATION RESULT

FBC : PCVWBC DIFF.PLATELETS

ELECTROLYTES UREA AND CREATININE On admission

WOUND SWAB M/C/S

MANAGEMENT

Days before debridement

Debridement bedside or theatre

Average number of debridement

Antibiotics intravenous duration

Oral duration

Sitz bath

Duration before commencing sitz bath

Days on admission

Blood Transfusion yes no

No of pints transfused

Surgical closure

Type of surgical closure

Referral yes or no

Colostomy

Death

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Odusanya, B.O., Saliu, N.A. & Salami, O.A. Fournier’s Gangrene: Management in a Poor Resource Setting. SN Compr. Clin. Med. 2, 209–214 (2020). https://doi.org/10.1007/s42399-020-00226-y

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