OBJECTIVE: The study aimed to describe the pen-operative complications of Fournier's gangrene in series of patients.

METHODOLOGY: A descriptive study was done using cross-sectional study design among patients diagnosed with Fournier's gangrene from January 1, 2010 to December 31, 2013. All patients regardless of age with extensive infection of the scrotum, genitalia, or perineum who underwent debridement and wide surgical excision of scrotal and/or perineal necrosis along with other involved areas and diagnosed with Fournier's gangrene postoperatively within the study period at JRRMMC was included in the study.

RESULTS: The study included 25 patients. Of these, 48% (12/25) of subjects with Fournier's gangrene had perioperative complication. Results also showed that number of hospital stay ranged from less than 24 hours to 42 days (mean of 10.5 days). Distribution of subjects by etiologic cause of Fournier's gangrene showed that majority of the etiologic cause of Fournier's gangrene were colorectal with 68% (17/25). Genital cause only comprised 32% (8/25) of the etiologic cause of Fournier's gangrene. The most frequent predisposing factor identified was diabetes mellitus.

CONCLUSION: Fournier's gangrene remains a surgical and urological emergency. Many patients may present with only minor skin lesions in the early stages of the disease. Rapid and accurate diagnosis remains a key component in achieving a successful outcome.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Fournier Gangrene-surgery, complications

OBJECTIVETo review the clinical characteristics and treatment strategies of Fournier's gangrene in HIV-positive patients.

METHODSWe retrospectively analyzed the clinical characteristics and therapeutic methods of 29 HIV-positive cases of Fournier's gangrene.

RESULTSThe patients were aged 21-81 (mean 34.2) years, 27 < or = 47 years and the other two 79 and 81 years old, respectively. All the patients were HIV positive and diagnosed as having Fournier's gangrene, with CD4+ T lymphocyte count < 320/mm3, and none had received any antiretroviral therapy. The two aged patients were complicated by diabetes mellitus. All the cases originated in scrotal or penile infection, with later involvement of the surrounding skin soft tissues. Aggressive surgical debridement, incision-drainage and broad-spectrum antibiotic medication were initiated right after admission, and scrotoplasty was performed for 4 cases. Twenty-six of the patients were recovered and the other 3 (10.3%) died after surgery, 1 from infectious shock and 2 from diabetes mellitus complicated by pulmonary infection and renal failure.

CONCLUSIONTimely aggressive surgical debridement, incision-drainage and broad-spectrum antibiotic medication are essential for the treatment of Fournier's gangrene in HIV-positive patients. We did not find any direct adverse impact of HIV infection on the prognosis of Fournier's gangrene.

Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; Debridement ; Fournier Gangrene ; complications ; surgery ; HIV Infections ; complications ; Humans ; Male ; Prognosis ; Retrospective Studies ; Scrotum ; surgery ; Young Adult