Abstract
Introduction
Fournier’s gangrene (FG) is the necrotizing fasciitis of the perineum and genital area. The objective of this study was to assess risk factors for mortality.
Materials and methods
We conducted an analytic and retrospective study of the patients with FG treated at our institution between 1998 and 2008. Statistical analysis was performed with the Statistical Package for Social Science for Windows, version 15.0, using the Mann–Whitney test for quantitative variables, and the chi-square and Fisher exact tests for qualitative variables, in univariate analyses.
Results
Of the 34 patients treated, 25 survived (74%) and 9 died (26%) with a median timing of 29 days (13, 60). Statistically significant differences were not found in age, sex and predisposing factors, except heart disease (p = 0.034). Admission laboratory parameters and severity criteria showed significant differences in serum urea (p = 0.007), potassium (p = 0.008), alkaline phosphatase (p = 0.014) and Fournier’s gangrene severity index score (FGSIS) (p = 0.008). Others factors such as duration of symptoms before hospital admission, extent of body surface area, number of surgical debridements, additional surgical manoeuvers (supra-pubic catheterization or colostomy), microbiological cultures and ICU stay did not show significant differences.
Conclusions
FG is a life-threatening necrotizing fasciitis with a high mortality rate. In our study, prognostic variables were heart disease, admission serum urea, potassium, alkaline phosphatase, and FGSIS. More studies are needed to validate these findings.
Similar content being viewed by others
References
Fournier AJ. Gangrene foudroyante de la verge. Sem Med. 1883;3:345–8.
Eke N. Fournier’s gangrene: a review of 1726 cases. Br J Surg. 2000;87:718–28.
Ecker K, Baars A, Töpfer J, Frank J. Necrotizing fasciitis of the perineum and the abdominal wall—surgical approach. Eur J Trauma Emerg Surg. 2008;3:219–28.
Laor E, Palmer L, Tolia B, Reid R, Winter H. Outcome prediction in patients with Fournier’s gangrene. J Urol. 1995;154:89–92.
Medina J, Tejido A, de la Rosa F, Felip N, Blanco M, Leiva O. Gangrena de Fournier: estudio de los factores pronósticos en 90 pacientes. Actas Urol Esp. 2008;32:1024–30.
Clayton M, Fowler J, Sharifi R, Pearl R. Causes, presentation and survival of fifty-seven patients with necrotizing fasciitis of the male genitalia. Surg Gynecol Obstet. 1990;170:49–55.
Tuncel A, Aydin O, Tekdogan U, Nalcacioglu V, Capar Y, Atan A. Fournier’s gangrene: three years of experience with 20 patients and validity of the Fournier’s gangrene severity index score. Eur Urol. 2006;50:838–43.
Corcoran A, Smaldone M, Gibbons E, Walsh T, Davies B. Validation of the Fournier’s gangrene severity index in a large contemporary series. J Urol. 2008;180:944–8.
Yeniyol C, Suelozgen T, Arslan M, Aayder A. Fournier’s gangrene: experience with 25 patients and use of Fournier’s gangrene severity index score. Urology. 2004;64:218–22.
Unalp H, Kamer E, Derici H, Atahan K, Balci U, Demirdoven C, Nazli O, Onal M. Fournier’s gangrene: evaluation of 68 patients and analysis of prognostic variables. J Postgrad Med. 2008;54:102–5.
Korkut M, Icoz G, Dayangac M, Akgun E, Yeniay L, Erdogan O. Outcome analysis in patients with Fournier’s gangrene. Dis Colon Rectum. 2003;46:649–52.
Palmer L, Winter H, Tolia B, Reid R, Laor E. The limited impact of involved surface area and surgical debridement on survival in Fournier’s gangrene. Br J Urol. 1995;76:208–12.
Chawla S, Gallop C, Mydlo J. Fournier’s gangrene: an analysis of repeated surgical debridement. Eur Urol. 2003;43:572.
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
García Marín, A., Martín Gil, J., Vaquero Rodríguez, A. et al. Fournier’s gangrene: analysis of prognostic variables in 34 patients. Eur J Trauma Emerg Surg 37, 141–145 (2011). https://doi.org/10.1007/s00068-010-0028-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00068-010-0028-7