关键词: Fournier坏疽, 坏死性筋膜炎, 负压引流, 皮肤移植, 皮瓣修复

Abstract:

Objective To observe the clinical manifestations and treatment outcomes of 40 patients with Fournier’s gangrene （FG）， and to explore the application prospects of modified negative pressure drainage and irrigation technique in the treatment of FG. Methods A retrospective analysis on the clinical data of 40 FG patients collected in our department was conducted. The patients were treated with surgical debridement combined with negative pressure irrigation technique. The etiology， complications， clinical manifestations， pathological examination results， laboratory examination results， wound bacterial culture， and postoperative hospital stay of the patients were recorded； and the wound healing and long-term follow-up outcomes of the patients were observed. Results Among these 40 patients， there were 35 males and 5 females， whose age were from 22 to 81 years old. There were 28 cases with perianal infection， 11 cases of diabetes， 5 cases of trauma， 1 case of pressure sore due to paraplegia， and 6 cases with no obvious cause. The pathological examination results showed the chronic suppurative inflammation with abscess formation. The surgical debridement was performed， and the wound treatment was carried out by covering the wound with negative pressure and modified drainage and irrigation technique based on the wound condition. All the patients were cured and discharged without recurrence. The average hospital stay was 24.65 d. Among the 25 patients with perianal abscess， no obvious stenosis occurred after surgery； 8 patients with involvement of the scrotum recovered well with normal appearance and function； 7 patients with skin grafting had good growth of the grafts； 2 patients with flap repair had good blood supply to the flaps without redness or rupture； 8 patients with involvement of the lower limbs had good recovery of motor and sensory function without obvious disabilities or hypertrophic scars. Conclusion The use of surgical debridement combined with negative pressure drainage and irrigation technique in the treatment of FG is beneficial for the observation of the changes in the wound， reducing dressing changes， shortening the hospital stay， improving the cure rate， and is worthy of clinical promotion.

Key words: Fournier’s gangrene, Necrotizing fasciitis, Negative pressure drainage, Skin transplantation, Flap reconstruction