已发表论文

Fournier 坏疽的多学科治疗进展

 

Authors Zhang KF, Shi CX, Chen SY , Wei W 

Received 15 September 2022

Accepted for publication 10 November 2022

Published 28 November 2022 Volume 2022:15 Pages 6869—6880

DOI https://doi.org/10.2147/IDR.S390008

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Héctor M Mora-Montes

Abstract: Fournier’s gangrene (FG) is a life-threatening and special form of necrotizing fasciitis, characterized by occult onset, rapid progress and high mortality, occurring mainly in men over 50 years of age. Risk factors of FG include diabetes, HIV infection, chronic alcoholism and other immunosuppressive state. FG was previously considered as an idiopathic disease, but in fact, three quarters of the infections originated from the skin, urethra and gastrointestinal tract. Initial symptoms of FG are often inconsistent with severity and can progress promptly to fatal infection. Although the treatment measures of FG have been improved in recent years, the mortality does not seem to have decreased significantly and remains at 20% – 30%. The time to identify FG and the waiting period before surgical debridement are directly related to the prognosis. Therefore, in addition to the combination of intensive fluid resuscitation and broad-spectrum antibiotics, treatment of FG should particularly emphasize the importance of early surgical debridement assisted with fecal diversion and skin reconstruction when necessary. This paper is to briefly summarize the progress in the definition, epidemiology, clinical manifestations, diagnosis, treatment and prognosis of Fournier’s gangrene in recent years, more importantly, illustrates the importance of multidisciplinary cooperation in the management of FG.
Keywords: Fournier’s gangrene, necrotizing fasciitis, lethal infection, surgical debridement, multidisciplinary cooperation