Fournier's gangrene (FG) is rare disease characterized by an acute, often polymicrobial, necrotizing soft tissue infection of the perineal and genital region, possibly extending into the abdominal wall. Diabetes mellitus, vascular diseases, morbid obesity, alcoholism, and intravenous drug abuse are found to be frequently predisposing comorbidities for FG.
Case description
60 years old NIDDM male patient presented to ER with perianal abscess. Ambulatory incision, evacuation of pus and drainage was done immediately. 3rd day post incision readmission with fever, painful erythema with crepitation extending from perineum up to interspinal line, fluctuation on left scrotum L 28.14, CRP 191.2 Laparotomy, APN of transverse colon followed with multiple incisions and extensive debridement. Gram + and Gram – pathogens were isolated. 5th postoperative day we started with NPWT. 6 changes of NPWT dressings (in average every 4.2 days) in total.
Discussion/Conclusion
Use of NPWT as a treatment of Fournier’s gangrene met our expectations. From each NPWT dressing change we observed rapid improvement of wound status and formation of granulation tissue. Patient compliance was excellent. 25 days after initial placement of NPWT wound edges were brought together with excellent result.
Clinical relevance
We advocate NPWT as a standard treatment of Fournier’s gangrene
Acknowledgements
This case report is done with patient permission.
Conflict of Interest
No conflict of interest
