Management of Fournier's gangrene : a practical guide for clinicians
Bowen, Daniel Saeed, Kordo Juliebø-Jones, Patrick
Bowen, Daniel
Saeed, Kordo
Juliebø-Jones, Patrick
Abstract
Fournier's gangrene is a localised form of necrotising fasciitis affecting the external genitalia, perineal and perianal regions. Although rare, it is associated with high rates of morbidity and mortality, so clinician awareness is essential for prompt treatment. Risk factors include diabetes mellitus, hypertension, chronic alcoholism and immunosuppression. Perineal pain in patients with sepsis should be treated with a high level of suspicion and early surgical referral is required as prompt debridement can improve outcomes. Repeated surgical intervention and antimicrobial therapy are often needed and recovery can take a long time, with a long-term impact on quality of life. This article discusses the natural history of Fournier's gangrene, aetiology, risk factors, investigations and treatments with an algorithm to support clinical practice.
Keywords: Antibiotics; Fournier's gangrene; Necrotising fasciitis; Surgical debridement.
MIDER Authors
Affiliations
South Warwickshire University NHS Foundation Trust; Mid and South Essex NHS Foundation Trust; University Hospital Southampton NHS Foundation Trust; University of Southampton; Haukeland University Hospital, Bergen, Norway
Date
2023-09-02
Type
Article
Subject
Collections
Citation
Hughes T, Bowen D, Saeed K, Juliebø-Jones P, Somani B. Management of Fournier's gangrene: a practical guide for clinicians. Br J Hosp Med (Lond). 2023 Sep 2;84(9):1-9. doi: 10.12968/hmed.2023.0119. Epub 2023 Sep 27.