대한대장항문학회

Purpose : Fournier's gangrene is a rapidly progressive (and aggressive), necrotizing<br>fasciitis of the genitalia and perineum. Despite the use of broad spectrum antibiotics and<br>surgical debridement, morbidity and mortality remain significant. The purpose of this study is<br>to investigate and evaluate the clinical and laboratory characteristics of this disease. Methods<br>: We reviewed 17 cases of Fournier's gangrene during 10 years from January, 1990 to<br>December, 1999. We retrospectively analyzed these patients and considered several factors,<br>which were age, sex, combined and etiologic factors, symptom and location of infection,<br>duration of admission, operation and its complication, result of bacterial culture and<br>sensitivity of antibiotics, morbidity and mortality. Results : the mean age was 47.4 years with<br>an age range of 3 to 77. The etiologies included unknown (65.7%), anorectal infection (23.5%)<br>and hemorrhoidectomy (11.8%). The combined diseases (predisposing factors) included<br>diabetes mellitus (52.9%), alcohol abuse, steroids or chemotherapy, liver cirrhosis and<br>malignancy. Aggressive surgical debridement with broad spectrum antibiotics therapy was<br>done on 16 patients, 1 patient refused operation. There were 3 colostomy cases, one<br>orchiectomy, one suprapubic cystostomy case. The most common cultured organism was<br>E.coli, 8 cases (53.3%). The mean hospital stay was 32.9 days. 3 patients (17.6%) were died<br>due to sepsis and multiorgan failure. Conclusions : Our results showed that the early<br>recognition, aggressive debridement of devitalized tissue, antibiotic therapy, search for<br>primary source are considered as the treatment of choice for Fournier's gangrene.<br>