A contemporary update on Fournier's gangrene

Nat Rev Urol. 2017 Apr;14(4):205-214. doi: 10.1038/nrurol.2016.243. Epub 2016 Dec 13.

Abstract

Despite advances in the evaluation, treatment, and pathophysiological understanding of necrotizing soft-tissue infections, Fournier's gangrene remains a life-threatening urological emergency. Although the condition can affect patients of any age and gender, it might be more prevalent in some high-risk groups with certain comorbidities. Several prognostic and diagnostic tools have been developed to assist with clinical decision-making once the diagnosis is made - primarily based on the physician's physical exam and potentially supported by laboratory and imaging findings. Expedited treatment with resuscitation, antibiotic administration, and rapid, wide surgical debridement are key elements of the initial management. These procedures must be followed by meticulous wound care and liberal use of planned subsequent surgical debridements. Once the patient has overcome the associated systemic illness, several reconstructive options for the genitalia and perineum can be considered to improve functionality and cosmesis.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Debridement / methods
  • Female
  • Fournier Gangrene / diagnostic imaging*
  • Fournier Gangrene / therapy*
  • Humans
  • Male
  • Perineum / diagnostic imaging*
  • Perineum / surgery
  • Prognosis
  • Risk Factors
  • Scrotum / diagnostic imaging*
  • Scrotum / surgery

Substances

  • Anti-Bacterial Agents