Experiencia y revisión de la literatura en el manejo de gangrena de Fournier en una institución, 2008-2015

Q4 Medicine
J.E. Sedano-Basilio, V. Cornejo-Dávila, L. Trujillo-Ortiz, M. Cantellano-Orozco, G. Fernández-Noyola, C. Martínez-Arroyo, J.G. Morales-Montor, C. Pacheco-Gahbler
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引用次数: 3

Abstract

Background

Fournier's gangrene is characterized by necrosis and gangrene of the subcutaneous tissue, superficial and deep fascia, and muscles in the perineum and genitals. The risk factors are: alcoholism, diabetes, malnutrition, advanced age, and immunosuppression. Treatment is based on broad-spectrum antibiotics and radical surgical debridement.

Aim

To report our institutional experience in the treatment of Fournier's gangrene.

Material and Methods

A retrospective, analytic study was conducted that included 46 patients attended to within the time frame of 2008-2015.

Results

Low socioeconomic level was the most frequent factor (61.4%), followed by diabetes (52.3%). Multiple surgeries were required in 79.5% of the cases and the mortality rate was 6.8%. A total of 68.3% of the cases had a urologic origin, followed by soft tissue involvement (27.3%), and the most frequent microorganism was Escherichia coli (61.4%).

Discussion

Treatment included broad-spectrum antibiotics (carbapenems) and radical surgical treatment; vacuum-assisted closure was recommended. Once a negative culture was obtained, rehabilitation and reconstruction were carried out to optimize the functional capacity of the patients. In our population, economic limitations and treatment abandonment limited the described management.

Conclusions

Fournier's gangrene presents with a critical mortality rate. Initial aggressive antibiotic and surgical treatment improves survival and later rehabilitation and reconstruction improve functional capacity.

2008-2015年机构福涅尔坏疽管理的经验与文献综述
富尼耶坏疽的特征是皮下组织、浅筋膜和深筋膜以及会阴和生殖器肌肉的坏死和坏疽。危险因素有:酗酒、糖尿病、营养不良、高龄和免疫抑制。治疗是基于广谱抗生素和根治性手术清创。目的报告我院治疗富尼耶坏疽的经验。材料与方法对2008-2015年间收治的46例患者进行回顾性分析研究。结果社会经济水平低是最常见的因素(61.4%),其次是糖尿病(52.3%)。79.5%的病例需要多次手术,死亡率为6.8%。泌尿系统感染占68.3%,其次是软组织感染(27.3%),最常见的微生物是大肠杆菌(61.4%)。治疗包括广谱抗生素(碳青霉烯类)和根治性手术治疗;建议采用真空辅助封闭。一旦获得阴性培养,进行康复和重建,以优化患者的功能能力。在我国人口中,经济限制和放弃治疗限制了所描述的管理。结论富尼耶坏疽病死率高。最初积极的抗生素和手术治疗可提高生存率,后来的康复和重建可改善功能能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Revista mexicana de urologia
Revista mexicana de urologia Medicine-Urology
CiteScore
0.20
自引率
0.00%
发文量
49
期刊介绍: Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.
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