Objective: In this study, we aimed to com- pare the outcomes of patients who underwent Vacuum Assisted Closure (VAC) and conven- tional rivanol dressing (RD) treatment after sur- gical debridement due to Fournier Gangrene in our clinic.
Material and Methods: Ninety-six patients treated at our clinic for Fournier Gangrene were included in the study. The patients were divided into two groups; VAC applied patients (Group A, n = 56) and conventional RD applied patients (Group B, n = 40) after debridement. Patient’s demographic data, duration of hospital stay, secondary debridement requirements, necrosis area, and location, wound healing times, ure- thral stricture history, perioperative colostomy requirement, percutaneous cystostomy require- ment, orchiectomy need, septic shock presence, etiology of Fournier Gangrene, mortality rate and Fournier Gangrene Severity Index Score were compared. Independent Groups t-test, Mann-Whitney U test, chi-square test and Fish- er’s exact test were used for statistical analysis. A p value of less than 0.05 was considered for sta- tistical significance.
Results: The duration of hospitalization (days) and wound healing time were shorter (p= 0.018 and p = 0.026) and the number of pa- tients requiring secondary debridement was less (p = 0.011) in the VAC applied group. In the multivariate regression analysis, the size of the necrosis area, wound healing time, perioperative colostomy requirement, the presence of septic shock and Fournier Gangrene Severity Index Score were independent variables that significantly affected the mor- tality rate.
Conclusions: Fournier Gangrene is a disease that may be a sig- nificant cause of mortality despite the alternative treatment methods. VAC is an important postoperative treatment and wound-care meth- od, with a shorter hospitalization period and faster recovery time.
Keywords: necrotizing fasciitis, fournier gangrene, debridement, negative-pressure wound therapy.
Abstract
Objective: In this study, we aimed to com- pare the outcomes of patients who underwent Vacuum Assisted Closure (VAC) and conven- tional rivanol dressing (RD) treatment after sur- gical debridement due to Fournier Gangrene in our clinic.
Material and Methods: Ninety-six patients treated at our clinic for Fournier Gangrene were included in the study. The patients were divided into two groups; VAC applied patients (Group A, n = 56) and conventional RD applied patients (Group B, n = 40) after debridement. Patient’s demographic data, duration of hospital stay, secondary debridement requirements, necrosis area, and location, wound healing times, ure- thral stricture history, perioperative colostomy requirement, percutaneous cystostomy require- ment, orchiectomy need, septic shock presence, etiology of Fournier Gangrene, mortality rate and Fournier Gangrene Severity Index Score were compared. Independent Groups t-test, Mann-Whitney U test, chi-square test and Fish- er’s exact test were used for statistical analysis. A p value of less than 0.05 was considered for sta- tistical significance.
Results: The duration of hospitalization (days) and wound healing time were shorter (p= 0.018 and p = 0.026) and the number of pa- tients requiring secondary debridement was less (p = 0.011) in the VAC applied group. In the multivariate regression analysis, the size of the necrosis area, wound healing time, perioperative colostomy requirement, the presence of septic shock and Fournier Gangrene Severity Index Score were independent variables that significantly affected the mor- tality rate.
Conclusions: Fournier Gangrene is a disease that may be a sig- nificant cause of mortality despite the alternative treatment methods. VAC is an important postoperative treatment and wound-care meth- od, with a shorter hospitalization period and faster recovery time.
Keywords: necrotizing fasciitis, fournier gangrene, debridement, negative-pressure wound therapy.