Fournier kangreninde mortaliteye etkili faktörler

Factors Effecting Mortality in Fournier’s Gangrene

BACKGROUND: Fournier’s gangrene is the most serious and life threatening infection. The aim of this retrospective study is to describe effective factors on mortality in Fournier’s gangrene. METHODS: Thirty three patients with Fournier’s gangrene were investigated retrospectively. The variables such as age, gender, etiological and predisposing factors, symptoms, physical signs, intervals between symptoms and hospital admission, laboratory findings, types of microorganisms isolated from the wound scrapings, the number of surgical debridements, the length of hospitalisations were evaluated and their effects on mortality were analysed. The diagnosis of Fournier’s gangrene was established with a detailed anamnesis nad physical examination. Ultrasonographic (US) and computerized tomographic examinations were performed in case of suspected involvement of adjacent tissues. RESULTS: The overall mortality rate was 33.3% in this series. The median duration of symptoms was 6.5 days in patients who survived and 10 days in patients who died (p<0.05). Only the increase in mortality in the presence of tachycardia and anaemia were was statistically significant. CONCLUSION: It was concluded that early diagnosis, stabilization of hemodynamic status, repeated debridements of whole necrotic tissue combined with antibiotherapy, before establishment of anemia and tachicardia due to multiple organ failure, might decrease mortality in patients with Fournier’s gangrene.