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KMID : 0371320060710040274
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Journal of the Korean Surgical Society
2006 Volume.71 No. 4 p.274 ~ p.279
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Fournier’s Gangrene: Clinical Analysis of 11 Patients
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김상기/Kim SK
박정인/주영태/박순태/하우송/홍순찬/이영준/정은정/정치영/최상경/Park JI/Joo YT/Park ST/Ha WS/Hong SC/Lee YJ/Jung EJ/Jeung CY/Choi SK
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Abstract
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Purpose: Fournier’s gangrene is a rare and rapidly progressive infection of the genitalia, perineum, and abdominal wall. The mortality rate from this infection ranges from 0 to 67 percent. One of the most important determinants of the overall outcome is early recognition and extensive surgical debridement combined with broad-spectrum antibiotics therapy. The objective of this study was to review the clinical outcomes of 11 consecutive patients who suffered with Fournier’s gangrene and the related medical literature to highlight the current status of this disease.
Methods: We retrospectively reviewed the records of 11 patients with the Fournier’s gangrene who had been treated at Gyeongsang National University Hospital between March 1995 and March 2005.
Results: The mean age was 60 years (range: 38∼82), and the male to female ratio was 8：3. The most common cause of Fournier’s gangrene was perianal abscess (n=4, 36.3%) and the most common disease associated with Fournier’s gangrene was diabetes mellitus (n=6, 54.5%). The most common cultured organisms were E. coli and K. pneumoniae. We performed aggressive surgical debridement combined with broad spectrum antibiotics therapy. The number of surgical procedures per patients ranged between 1 and 7 (mean: 2.63). Diverting colostomy was required in 36.3% (n=4) of the cases. Two cases received reconstructive plastic surgery. The mortality rate of 11 patients was 27.2% (n=3) and the cause of death was sepsis.
Conclusion: Fournier’s gangrene is a life-threatening disease, but the mortality rate can be diminished via early diagnosis, aggressive surgical intervention, and the use of broad- spectrum antibiotics. (J Korean Surg Soc 2006;71:274-279)
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