Table of Contents
ISRN Surgery
Volume 2012 (2012), Article ID 942437, 8 pages
http://dx.doi.org/10.5402/2012/942437
Review Article

Fournier’s Gangrene: Current Practices

Department of General Surgery, Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore 560002, India

Received 6 October 2012; Accepted 24 October 2012

Academic Editors: S. Schulze and V. Vecsei

Copyright © 2012 M. N. Mallikarjuna et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fournier’s gangrene is an acute, rapidly progressive, and potentially fatal, infective necrotizing fasciitis affecting the external genitalia, perineal or perianal regions, which commonly affects men, but can also occur in women and children. There has been an increase in number of cases in recent times. Despite advanced management mortality is still high and averages 20–30%. Early diagnosis using Laboratory Risk Indicator for Necrotizing Fasciitis score and stratification of patients into high risk category using Fournier's Gangrene Severity Index score help in early initiation of treatment. Triple antibiotic combined with radical debridement is the mainstay of treatment. There have been many advances in management of Fournier gangrene including use of vaccum assisted closure and hyperbaric oxygen therapy. With introduction of newer devices like Flexi-Seal, fecal diversion can be done, avoiding colostomy. Reconstruction of perineal defects using skin grafts, flaps, and urethral reconstruction using gracilis flaps can reduce the morbidity associated with FG and provide acceptable functional and aesthetic outcomes.