Case: Fournier necrotizing fasciitis. Necessity of multidirectional wound therapy Surgery + HBOT + NPWT.

This paper describes the treatment of a 48-year-old man with history of insulin-dependent diabetes mellitus admitted to the Surgical Department because of advanced purulent inflammation of the perineum, scrotum and buttocks in the course of Fournier's gangrene.

Initial, surgical treatment in Surgery Unit of progressive purulent lesions required continuation of treatment of severe general condition and local crotch soft tissue defects.

After the bridge therapy with hyperbaric oxygen, conventional dressing was applied for a total period of 29 days, vacuum therapy was implemented in the area of the greatest damage. Mastering the wound infection and simultaneous healing progress made it possible to close the defect and end 52 days of hospitalization.