Introduction:

Fournier gangrene is a rare and fatal disease that occurs primarily in young adult patients with immune system deficiency. The progression is usually rapid and fulminant and comes to affect and spread through the abdominal fascias. Treatment consists of antibiotics and aggressive surgical debridement. Despite timely and aggressive management most studies report high mortality.

Material and methods:

The records of 22 patients admitted from January 2007 to December 2015 were retrospectively reviewed. Two groups were formed: group 1, treated with conventional surgical debridements, and; group 2, treated with VAC system. The variables analized were: time of onset of the symptoms, comorbidities, origin of the disease, number of surgical debridements, VAC system placement, primary closure, hospital stay, morbidity and mortality.

Results:

From the 22 patients, 14 (63.6%) were in group 1 and eight (36.3%) were in group 2. Primary closure was achieved in four (50%) patients in group 2 and two (14.2%) in group 1 (p = 0.07). The median value of hospital stay were 24 days (range, four a 76) in group 1 and 17 days (range, one a 42) in group 2 (p = 0.23). The median value of surgical debridements were 12 (range, one a 49) in group 1 and eight (range, one a 24) in group 2 (p = 0.064). Overall mortality was six (27.2%); four (18.8%) patients of the group 1 and two (9%) of group 2 (p = 0.7).

Conclusions:

Patients treated with VAC system had a higher probability to achieve primary closure, less number of surgical debridements and shorter hospital stay.

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