DISCLAIMERS

contact us >>

Fournier's Gangrene: improving outcomes with serial debridement skin preservation and delayed primary closure

Travis Perry MD, Eileen Curry MD R. Michael Johnson MD
Wright State University
2017-02-15

Presenter: Eileen Curry

Affidavit:
A portion of this work will be presented at the American Burn Association. this abstract will focus more on hospital charges so it is not completely identical.

Director Name: R. Michael Johnson

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

Introduction:
Fournier's Gangrene (FG) remains a formidable disease that requires a high degree of suspicion followed by early diagnosis, prompt surgical intervention and targeted antibiotic therapy. Historically, surgical management consisted of wide radical excision. This leads to large wounds requiring complex soft tissue coverage and prolonged hospitalizations. An alternative to wide resection of skin and healing by secondary intention or skin grafting is serial debridement and delayed primary closure(SD/DPC)
Methods: The current work is a case series of 13 consecutive patients with FG treated with serial debridement, skin preservation and delayed primary closure technique.
Results: The mean number of surgeries was 5.76. The average number of days from initial consult to wound closure was 27.61 days. Ninety-two percent required no surgical fecal diversion. Delayed primary closure (DPC) was achieved in 100% of the patients. Only 1.5% of initial wound area required split thickness skin grafting as part of wound closure. There were no mortalities in this group of patients. The average ICU and hospital length of stays were 3.07 and 18.46 days respectively. Greater than sixty percent (61.5%) were partially managed as an outpatient during wound closure. Hospital charges were reviewed to estimate the financial benefit of this technique over healing by secondary intention or radical resection and skin grafting.
Conclusion:
Serial skin sparing debridement and delayed primary closure is an aggressive option that can lead to improved outcomes in the treatment of Fournier's Gangrene.

Ohio,Pennsylvania,West Virginia,Indiana,Kentucky,Pennsylvania American Society of Plastic Surgeons

OVSPS Conference