Fournier's gangrene: a review of 1726 cases.

摘要: Background: Although there is much consensus, certain controversies exist regarding the management of Fournier's gangrene. Method: Publications in English on gangrene from January 1950 to September 1999 were obtained through Medline database and relevant reference lists publications. It was possible identify 1726 cases for study. Data extracted review included country reported cases, number patients each report clinical features. Results: Fournier's occurs worldwide. However, its definition has generated considerable controversy as efforts are made refine original description light increasingly understood aetiological factors. Attempts classify disease into primary secondary forms have not been successful. The basic pathological process, necrotizing fasciitis, identified perineum women children, although afflicts male more often than female. Most occurred USA Canada. major sources sepsis local skin, colon, anus rectum, lower urinary tract. Colonic, anal rectal carry worst prognosis. Diabetes mellitus important terms. Rare causes include vasectomy circumcision. Investigations essential define cause an episode but diagnosis disease. Early aggressive treatment underlying conditions essential. Hyperbaric oxygen honey modalities yet be universally adopted. Risk death, 16 per cent overall this series, related patient's condition at presentation. Conclusion: Controversies over persist these do affect options. grounds. occurrence under-reported may go unrecognized by some clinicians. Some options, such hyperbaric oxygenation radical excision, remain controversial. © 2000 British Journal Surgery Society Ltd