Abstract

LARSSON, Juan C. et al. Combined surgical approach as a less invasive alternative for the treatment of Fournier's Gangrene. Cir. plást. iberolatinoam. [online]. 2017, vol.43, n.1, pp.87-96. ISSN 1989-2055.

Background and Objective: Fournier's gangrene is a necrotizing fasciitis of the perirectal, perianal and genital areas with a high morbimortality rates due to late diagnosis and associated patient's comorbidities. Adjuvant therapies including vacuum therapy and acellular matrix have proved to be effective in the treatment of complex soft tissue defects and now are part of our treatment protocol for this condition. The purpose of this study was to describe the advantages of our surgical approach applied in patients with complex perineal defects secondary to Fournier's gangrene Methods. We conduct a retrospective study describing 3 consecutive cases in males treated for complex soft tissue defects due to Fournier's gangrene according to our surgical protocol. It consists ofa step-by-step approach that begins with aggressive surgical debridement and vacuum in the first stage, continues with an intermediate stage based on the combination of dermal regeneration template and negative pressure wound therapy to prepare for the reconstruction phase where final defect coverage is accomplished. Results. Our 3 patientspresented with extensive perineal and regional compromise including external genitalia and lower limbs. All 3 cases were successfully treated with this approach leaving no functional sequela and restoring contour. Conclusions. This approach proved to be an efficient treatment alternative forFournier's gangrene.The combination of negative pressure wound therapy and acellular matrix simplified wound caring and led to safer and less morbid reconstructionsby primary wound closure and regional advancement flaps.

Keywords : Fournier Gangrene; Negative pressure wound therapy; Dermal regeneration template; Perineal reconstruction.

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