Fournier Gangrene
Fournier gangrene is a necrotizing soft tissue infection of the male perineum, although similar infections have been described in women. It is a type of necrotizing fasciitis, distinguished by its location of origin and the vast majority of cases being mi
- PDF / 417,751 Bytes
- 8 Pages / 504.57 x 720 pts Page_size
- 0 Downloads / 182 Views
Fournier Gangrene Tristan L. Hartzell and Dennis P. Orgill
Contents
32.1
32.1 Introduction and History ............................
187
32.2 Physiopathogeny ..........................................
188
32.3 Diagnosis ......................................................
189
32.4 Treatment .....................................................
190
32.5 Reconstruction .............................................
192
Conclusion ..............................................................
193
References ...............................................................
193
T.L. Hartzell, MD Faith Regional Physician Services Hand, Plastic and Reconstructive Surgery, Faith Regional Health System, 301 N. 27th Street, Suite 8, Norfolk, NE 68701, USA e-mail: [email protected] D.P. Orgill, MD, PhD (*) Division of Plastic Surgery, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115, USA e-mail: [email protected]
Introduction and History
Fournier gangrene is a necrotizing soft tissue infection of the male perineum, although similar infections have been described in women. It is a type of necrotizing fasciitis, distinguished by its location of origin and the vast majority of cases being mixed infections of aerobic and anaerobic bacteria. It is characterized by a rapidly spreading soft tissue infection that travels along perineal subcutaneous fascial planes and obliterates perforating skin vessels but spares underlying muscle. High mortality rates have resulted in a heightened awareness by surgeons with a low threshold for intervention. Severe, life-threatening soft tissue infections have been recognized throughout history. Hippocrates first described necrotizing fasciitis in the fifth century BC. It was not until 1764, however, that Baurienne first described a case of scrotal gangrene, characterized by a fast spreading necrotizing infection. The disease ultimately took its name from Jean Alfred Fournier, a French venereologist who described five cases of perineal gangrene in clinical lectures in 1883 [1]. Even in this early practice of medicine and identification of a new disease process, academics recognized that diabetes and trauma were leading causes of Fournier gangrene. Fournier specifically described the ligation of the prepuce to control nighttime enuresis and archaic birth control regimens to prevent an adulterer from impregnating his married mistress as causes [1]. Herod the
L. Téot et al. (eds.), Skin Necrosis, DOI 10.1007/978-3-7091-1241-0_32, © Springer-Verlag Wien 2015
187
T.L. Hartzell and D.P. Orgill
188
Great and Segundo Ruiz Belvis, a Puerto Rican abolitionist and independence leader, are suspected to have died from Fournier gangrene. The number of annual cases of Fournier gangrene is difficult to ascertain, owing to inaccurate reporting, incorrect identification, and the many misnomers. Approximately 750 cases have been reported in the literature [2], and the prevalence has been estimated to be as high as 1 case in 7,500 persons [3], although these numbers may be
Data Loading...
