FOURNIER’S GANGRENE -CLINICAL REVIEW OF 50 PATIENTS

Registration ID: IJNRD_187691

Published ID: IJNRD2302210

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PROF.DR.J.A.JAYALAL, DR.JEKIN, DR.EDWIN KINS RAJ

Fournier’s gangrene, debridement, scrotum, morbidity

Background: Fournier’s gangrene is a devastating necrotizing fasciitis of the genitalia and perineum which can lead to polymicrobial infection of the region and organ failure or death. The goal of this study was to identify the pre-presence systemic comorbid conditions, the local predisposing factors, metabolic issues, early diagnosis, management challenges, and outcomes in Kanyakumari District. Fournier gangrene is a surgical emergency that results in a high mortality rate if proper diagnosis and early management are done. This polymicrobial necrotizing fasciitis of the perineal, perianal, and genital regions has a mortality rate ranging from 15% to 50%. Aims & Objectives: This study is intended to figure out the age and sex incidence, demographic pattern, predisposing etiological and risk factors, signs and symptoms, and the net result of patients, and to evaluate the optimal treatment modalities for Fournier’s gangrene. Methods: This study is carried out as an observational prospective study conducted in the Department of General Surgery Kanyakumari Government medical college from January 2021 to December 2022. A total of 50 cases of Fournier’s gangrene fulfilling the inclusion criteria were included in the study. Demographic data including age, gender, etiology, risk factors, clinical features, presenting signs and symptoms site of involvement, microbial culture bacterial flora, treatment modality applied, duration of hospital stay, and mortality were studied. Results: Total number of 50 patients with 46 males and 4 females were in the study. Males predominant were observed at 92 % with the ratio of male: female ratio of 11.5 :1. Females were presented with induration of the vulva, and abscess in the perineal or perianal area . On the basis of site, 31 ( 62%) had lesions in the scrotum, 8 patients (16%) in the perineum, 6 patients (12%) in the penis, 3 patients (6%) in the groin, and 2 patients (4%) in the vulva. Eight in the research group suffered total scrotum loss. The presentation with symptoms to the hospital was delayed with a mean presentation of 6.8 days following disease onset. Patients who reported late to the hospital reported much more severe morbidity, late recovery, and needed multiple debridements and prolonged hospital stays. Conclusions: This study suggests that if Fournier’s Gangrene can be diagnosed early and the patients report to the hospital early, with prompt debridement, metabolic control, and appropriate antibiotics effective positive outcome management can be done. Scrotum being a much elastic skin, primary closure and wound healing are possible even after much necrotic debridement. Patients having wider resulting soft tissue defects following debridement required surgical reconstruction, thus decreasing morbidity, hospital stay, and early return of patients to regular life. Strict metabolic control, proper hygiene, and early treatment are important tools to avoid this devastating disease.

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PROF.DR.J.A.JAYALAL, DR.JEKIN, & DR.EDWIN KINS RAJ (February-2023). FOURNIER’S GANGRENE -CLINICAL REVIEW OF 50 PATIENTS . INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT, 8(2), c57-c70. https://ijnrd.org/papers/IJNRD2302210.pdf

Volume 8 Issue 2, February-2023

Pages : c57-c70

Paper Reg. ID: IJNRD_187691

Published Paper Id: IJNRD2302210

Research Area: Medical Science

Author Type: Indian Author

Country: NAGERCOIL, TAMILNADU, India

Published Paper PDF: https://ijnrd.org/papers/IJNRD2302210.pdf

Published Paper URL: https://ijnrd.org/viewpaperforall?paper=IJNRD2302210

Journal Name: INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT(IJNRD)

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