Üçüncü basamak bir hastanede Fournier gangrenindeki deneyimlerimiz ve bunun kan sayýmý parametreleri ile iliþkisinin analizi

AMAÇ: Fournier gangreni, genital ve perineal bölgenin hýzla ilerleyen ve yaþamý tehdit eden nekrotizan fasiitidir. Fournier gangreni ile ilgili deneyimlerimizi paylaþmak ve klinik verilerin tam kan sayýmý parametreleri, enflamasyon hücreleri ve sistemik enflamasyon belirteçleri ile iliþkisini analiz etmek. GEREÇ VE YÖNTEM: Fournier gangreni tanýsý ile Ocak 2016–Aralýk 2020 arasýnda takip edilen ve tedavi edilen yetiþkin hastalarýn dijital týbbi kayýt-larý geriye dönük olarak analiz edildi. Veriler yaþ, cinsiyet, toplam hastanede kalýþ süresi, predispozan faktörler, etiyolojik faktörler, toplam debridman sayýsý, cerrahi iþlemler ve antibiyotik olarak belirlendi. Hastaneye yatýþýn ilk günü ile debridman sonrasý birinci ve yedinci günlerde ölçülen serum glikoz düzeyleri, tam kan sayým parametresi düzeyleri, serum inflamasyon göstergeleri ve C-reaktif protein düzeyleri ölçüldü.
BULGULAR: Yaþ ortalamasý 56.42 (22–86) yýl olan 36 erkek hasta alýndý. En yaygýn predispozan faktör diabetes mellitusdu (n=13; %36.1). En sýk görülen etiyolojik neden skrotal apseydi (n=19; %52.8). Debridman öncesi, debridman sonrasý birinci ve yedinci günlerde WBC sayýsýnda, nötrofil seviyesinde, NLR deðerinde ve CRP seviyesinde istatistiksel olarak anlamlý azalma saptandý (p<0.05). Ýlk baþvuru anýndaki debridman sayýsý ile yaþ, NLO, PLO ve CRP deðerleri arasýnda pozitif korelasyon vardý (p<0.05).
TARTIÞMA: Ürogenital bölge enfeksiyonlarý, Fournier gangreninin temel etiyolojik kökenidir. Nadir bir ürolojik acil durum olan Fournier gangreninde klinik verilerde ve kan sayýmý parametrelerinde önemli deðiþiklikler gözlendi.

Our experience on Fournier’s gangrene in a tertiary-stage care center and analysis of its relationship with blood count parameters

BACKGROUND: Fournier’s gangrene (FG) is rapidly progressing and life-threatening necrotizing fasciitis of genital and perineal regions. The aim of the study was to share our experience with FG and to analyze the relationship of clinical data with whole blood count parameters, inflammation cells, and systemic inflammation markers.
METHODS: The digital medical records of the adult patients followed-up and treated with diagnosis of FG between January 2016 to December 2020 were retrospectively analyzed. Data were as age, gender, total length of hospital stay, predisposing factors, etiological factors, total number of debridement’s, surgical procedures, and antibiotherapy were collected. Serum glucose levels, complete blood count parameter levels, serum inflammation indicators and C-reactive protein (CRP) levels measured at the initial day of hospital admission, post-debridement 1st and 7th days were measured.
RESULTS: Thirty-six male patients were included, with a mean age of 56.42 (22–86) years. The most common predisposing factor was diabetes mellitus (n=13; 36.1%). The most frequently seen etiological cause was scrotal abscess (n=19; 52.8%). A statistically significant decrease was found in White blood cell count, neutrophil level, neutrophil-to-lymphocyte ratio (NLR) value and CRP level measured before debridement, post-debridement 1st and 7th days (p<0.05). There was a positive correlation between the number of debridement’s and age, NLR, platelet-to-lymphocyte ratio, and CRP values at the initial admission time (p<0.05).
CONCLUSION: The infections of urogenital region are the essential etiological origin of FG. As a rare urological emergency, significant changes were observed in clinical data and blood count parameters during the course of FG.