Stepwise minimal debridement in Fournier's gangrene: a technical note

Abstract

Fournier's gangrene, so called after the French physician who first described this condition in 1883, is a necrotizing fasciitis of the perineum and the genitalia. It is a fulminant gangrene of the genitalia. It is a polymicrobial infection caused by gram-positive, gram-negative anaerobic bacteria.^1-4 The infection is said to spread along fascial planes. Its risk factors include alcoholism, diabetes mellitus, immunosuppression, obesity as well as complications of surgery of the perineum. Fournier's gangrene is a surgical emergency known to have a high mortality rate (16-40%). Its treatment requires resuscitation, debridement and broad spectrum antibiotics. Metronidazole, aminoglycoside, third generation cephalosporin.^1-2 Hyperbaric oxygen chambers have been added to its armamentarium but its efficacy remains controversial.^1-2,5-7