Comparison of vacuum-assisted closure therapy and debridement with primer surgical closure for fournier’s gangrene treatment: 10 years’ experience of a single centre

Vol. 43 (x): 2017 July 7.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2017.0052


ORIGINAL ARTICLE

Mustafa Ozan Horsanali 1, Utku Eser 2, Burcu O. Horsanali 3, Omer Altaş 3, Huseyin Eren 4
1 Department of Urology, Izmir Katip Celebi University Ataturk Training and Research Hos-pital, Izmir, Turkey; 2 Department of Family Medicine, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey; 3 Department of Anesthesiology and Reani-mation, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey; 4 Department of Urol-ogy, Recep Tayyip Erdogan University, Rize, Turkey

ABSTRACT

Objective: Fournier’s gangrene is a type of necrotizing soft tissue infection of the peri­neal, genital and perianal region that has a rapidly progressive and potentially fatal course. In the present study, our goal was to compare the patients submitted to surgical debridement for Fournier Gangrene with Vacuum-asisted Closure (VAC) and without VAC therapy after debridement.

Materials and Methods: We retrospectively analyzed 313 patients underwent surgical debridement for FG in our hospital. Patients were divided into two groups as patients performed surgical debridement with VAC therapy and surgical debridement with primer closure and without VAC therapy. Demographic characteristics, hospitalization time, re­quirement of re-constructive treatment, area of necrosis and localization, requiring per-operative colostomy, percutaneous cystostomy or orchiectomy status, presence of septic shock, etiology of Furnier Gangrene (FG) and Fournier gangrene severity index score were recorded for statistical analysis.

Results: 111 (35.5%) patients received vacuum-assisted closure therapy and remained 202 (64.5%) patients did not receive vacuum – assisted closure after surgical debridement due to Fournier’s gangrene. Mortality rate was calculated as 15.7%. Mean hospitalization time of patients were 23.7±1.1 days. The requirement of reconstructive surgery, septic shock, Fournier gangrene severity index, requirement of colostomy, mortality rate and hospitalization time was significantly lower in patients who received VAC therapy.

Conclusions: Vacuum-assisted closure therapy is suggested for the treatment of Fourni­er gangrene. Early implementation of vacuum – assisted closure therapy can decrease mortality rate and hospitalization time of patients with Fournier gangrene and increase the recovery time.

Keywords: Fournier Gangrene; Negative-Pressure Wound Therapy; Debridement; Fasciitis, Necrotizing

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