The Evaluation of Severity and Treatment of Fournier's Gangrene

Abstract

We experienced and evaluated 6 patients with Fournier's gangrene who underwent emergency surgery between January 2012 and December 2013. Two out of six patients with a high score on the Fournier's gangrene severity index (FGSI) and the Uldag Fournier’s gangrene severity index (UFGSI) died in the peri-operative period. Between 2008 and 2013, we collected 107 Japanese cases, including ours, and analyzed the clinical findings. Almost all of the patients were men and the average age was 59.3 years. The mortality rate was 10%. Almost all of the patients (84%) had preoperative complications the most frequent of which was diabetes. Anaerobic bacteria infection was associated with 35％ of the patients and many of the patients had a variety of mixed infections. Regarding the treatment of Fournier’s gangrene, adequate open drainage and debridement are essential, and administration of broad spectrum antibiotics and local control of wound are also important under intensive care. FGSI and UFGSI scores are useful for evaluation of the severity and prediction of the prognosis for the patients with Fournier’s gangrene.