FOURNIERʹS GANGRENE: A REVIEW OF 15 CASES

Objectives: To report the outcome of surgical management of Fournierʹs gangrene. Material and methods: This retrospective study evaluated 15 patients with Fournierʹs gangrene who had been managed in the Surgical Department of Khyber Teaching Hospital from July 2005 to June 2006. Their medical records were thoroughly studied. Study variables like co morbidities/risk factors, clinical features and surgical procedures were analyzed to determine their influence on the outcome. Results: All 15 patients were males with an age range of 41-65 years (mean: 52.46 years). According to their medical record concomitant weakening illnesses like diabetes mellitus, malnutrition, malignancy and immunosuppression were common risk factors. Six (40%) patients who survived and 3 (20%) patients who died had at least one of the aforementioned co morbid conditions. The most frequent co morbid condition was diabetes mellitus affecting 5 (33.33%) patients. E.coli, hemolytic streptococci and staphylococcus aureus were the common pathogens isolated. After admission they were resuscitated, parenteral broad-spectrum antibiotics were started and extensive multiple debridments were done. Hospital stay ranged from 9 to 35 days with a mean hospital stay of 21.66 days. Mortality rate was 3 (20%o) patients. Conclusion: Early recognition, timed presentation followed by aggressive resuscitation, proper intravenous antibiotics as well as extensive multiple debridments are significant factors to affect the outcome in the surgical treatment of Fournierʹs gangrene.