Tags

Type your tag names separated by a space and hit enter

Gangrene and Fournier's gangrene.
Urol Clin North Am. 1992 Feb; 19(1):149-62.UC

Abstract

Fournier's gangrene is an aggressive disease affecting the perineum. Clearly, it can no longer by considered idiopathic in its origin, as most infection can be localized to a cutaneous, urethral, or rectal source. It presents in a broad age range and can have an indolent onset, thus requiring a high index of suspicion. It may be fulminant and progressive in the case of immunocompromise and underlying debilitating illnesses. Despite aggressive antibiotic therapy and debridement, it is associated with a high mortality rate. This rate has been higher in older patients, those with a rectal focus, and diabetics. Hyperbaric oxygen therapy has shown some promise in shortening hospital stays, increasing wound healing, and decreasing the gangrenous spread when used in conjunction with surgical debridement and antibiotics. New reconstructive efforts, such as medial thigh myocutaneous flaps, have improved the cosmetic aftermath of the extensive debridement. Fournier's gangrene remains a true urologic emergency, which mandates aggressive initial care by means of early recognition, early hemodynamic stabilization, and the institution of parenteral broad-spectrum antibiotics. This is followed by multiple debridements and in some cases urinary or rectal diversion. The concomitant use of hyperbaric oxygen therapy in selected cases followed by meticulous reconstructive surgery and salvage has further reduced the mortality rate and improved the cosmetic outcome.

Authors+Show Affiliations

Department of Urology, Long Island Jewish Medical Center, New Hyde Park, New York.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

1736475

Citation

Paty, R, and A D. Smith. "Gangrene and Fournier's Gangrene." The Urologic Clinics of North America, vol. 19, no. 1, 1992, pp. 149-62.
Paty R, Smith AD. Gangrene and Fournier's gangrene. Urol Clin North Am. 1992;19(1):149-62.
Paty, R., & Smith, A. D. (1992). Gangrene and Fournier's gangrene. The Urologic Clinics of North America, 19(1), 149-62.
Paty R, Smith AD. Gangrene and Fournier's Gangrene. Urol Clin North Am. 1992;19(1):149-62. PubMed PMID: 1736475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gangrene and Fournier's gangrene. AU - Paty,R, AU - Smith,A D, PY - 1992/2/1/pubmed PY - 1992/2/1/medline PY - 1992/2/1/entrez SP - 149 EP - 62 JF - The Urologic clinics of North America JO - Urol Clin North Am VL - 19 IS - 1 N2 - Fournier's gangrene is an aggressive disease affecting the perineum. Clearly, it can no longer by considered idiopathic in its origin, as most infection can be localized to a cutaneous, urethral, or rectal source. It presents in a broad age range and can have an indolent onset, thus requiring a high index of suspicion. It may be fulminant and progressive in the case of immunocompromise and underlying debilitating illnesses. Despite aggressive antibiotic therapy and debridement, it is associated with a high mortality rate. This rate has been higher in older patients, those with a rectal focus, and diabetics. Hyperbaric oxygen therapy has shown some promise in shortening hospital stays, increasing wound healing, and decreasing the gangrenous spread when used in conjunction with surgical debridement and antibiotics. New reconstructive efforts, such as medial thigh myocutaneous flaps, have improved the cosmetic aftermath of the extensive debridement. Fournier's gangrene remains a true urologic emergency, which mandates aggressive initial care by means of early recognition, early hemodynamic stabilization, and the institution of parenteral broad-spectrum antibiotics. This is followed by multiple debridements and in some cases urinary or rectal diversion. The concomitant use of hyperbaric oxygen therapy in selected cases followed by meticulous reconstructive surgery and salvage has further reduced the mortality rate and improved the cosmetic outcome. SN - 0094-0143 UR - https://www.unboundmedicine.com/medline/citation/1736475/Gangrene_and_Fournier's_gangrene_ L2 - https://medlineplus.gov/gangrene.html DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.