Ghulam Hyder Rind, Sayed Qarib Abbas Shah, Khush Mohammad Sohu, Azhar Ali Shah.
Thierisch skin grafting for wounds in a general surgical ward.
Med Channel Jan ;16(2):287-9.
OBJECTIVE: The purpose of this study was to report our experience and results in the management of Fournier’s gangrene. STUDY DESIGN: Prospective case series study PLACE AND DURATION OF STUDY: This study was conducted in Surgical Unit-I Ghulam Mohammad Maher Medical College Hospital Sukkur from January 2007 to December 2009.` PATIENTS AND METHODS: During the study period the demographics of patients, duration of presenting symptoms, the etiology, predisposing factors, microbiological findings, duration of hospital stay, treatment and out comes were recorded on specially designed Performa and discussed in the light of published literature. RESULTS: 31 male patients with a mean age of 43.6year (range 25-78 year) presented with symptoms and signs of Fournier’s gangrene were studied. The source of infection was anorectal in 14 (45.2%) patients, urogenital in 6 (19.4%) patients, cutaneous in 2 (6.5%) patients and no cause was identified in The most common comorbid condition seen in this series was diabetes mellitus. Culture results revealed a polymicrobial infection in 18 patients (58.1%) while in 13 patients (49.1%) only one organism was identified. Five (16.2%) patients underwent suprapubic cystostomy for urinary diversion. Faecal diversion by sigmoid loop colostomy was done in three (9.7%) patients with gross involvement of perianal skin. Secondary procedures for the closure of the wound were done in 26 (83.9%) patients that survived. Five patients could not survive giving a mortality rate of 16.2%. CONCLUSION: Fournier’s gangrene is truly a life threatening surgical emergency. Early presentation and diagnosis, supportive measures, aggressive treatment with extensive debridement of the lesion and use of broad spectrum antibiotics remains the cornerstone of management.
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