Treatment, outcome and quality of life after Fournier's gangrene: a multicentre study

Colorectal Dis. 2013 Dec;15(12):1529-36. doi: 10.1111/codi.12396.

Abstract

Aim: The object of this study was to describe the course of Fournier's gangrene and assess quality of life in a group of affected patients.

Method: We evaluated patients who received inpatient treatment for Fournier's gangrene at five hospitals in northern Germany from 1995 to 2010. Surviving patients were asked to take part in a clinical follow-up and complete the Short-Form 36 (SF-36) quality-of-life questionnaire and a disease-specific questionnaire including a physical examination.

Results: Of the 86 patients, 72 (83.7%) were men. The mean age of the patients was 57.9 ± 13.9 (25-89) years. The mean length of hospital stay was 52.0 ± 54.0 (1-329) days. Fourteen (16.3%) patients (eight men) died primarily from Fournier's gangrene. The most common aetiological event was anogenital abscess formation (n = 24; 27.9%). Seventy-one (82.5%) patients had a mixed polymicrobial infection. SF-36 physical role functioning (P = 0.010), physical functioning (P = 0.008), general health (P = 0.010) and physical health summary (P = 0.006) scores were significantly lower than those of the normal population. Deterioration in sexual function was reported by 65% of the patients.

Conclusion: Patients with Fournier's gangrene experience persistent physical and mental health problems for a long period of time following their primary hospital stay and must receive long-term care from a variety of specialists, otherwise the disease leads to an increase in the duration of morbidity and a decrease in quality of life.

Keywords: Fournier's gangrene; necrotizing fasciitis; quality of life; sepsis; short-form-36.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteroidaceae Infections / complications
  • Bacteroidaceae Infections / psychology
  • Bacteroidaceae Infections / therapy
  • Coinfection / complications
  • Coinfection / psychology
  • Coinfection / therapy*
  • Debridement*
  • Enterobacteriaceae Infections / complications
  • Enterobacteriaceae Infections / psychology
  • Enterobacteriaceae Infections / therapy
  • Fasciitis, Necrotizing / complications
  • Fasciitis, Necrotizing / psychology
  • Fasciitis, Necrotizing / therapy*
  • Female
  • Follow-Up Studies
  • Fournier Gangrene / complications
  • Fournier Gangrene / psychology
  • Fournier Gangrene / therapy*
  • Genital Diseases, Female / complications
  • Genital Diseases, Female / psychology
  • Genital Diseases, Female / therapy*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Pseudomonas Infections / complications
  • Pseudomonas Infections / psychology
  • Pseudomonas Infections / therapy
  • Quality of Life*
  • Retrospective Studies
  • Sexual Dysfunction, Physiological / etiology
  • Sexual Dysfunction, Physiological / psychology
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / psychology
  • Staphylococcal Infections / therapy
  • Streptococcal Infections / complications
  • Streptococcal Infections / psychology
  • Streptococcal Infections / therapy
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents