Fournier Gangrene - a mutilating condition
A 47-year-old patient, with no significant medical history, is admitted to the surgery service for considerable pain in the perianal and scrotal regions, with onset of several weeks, neglected, accentuated progressively. The clinical examination reveals an area of skin necrosis that includes the perianal and scrotal region, suggestive of "Fournier Gangrene " (Figure 1). Under spinal anaesthesia, emergency surgery was performed, making large incision with evacuation, digital and instrumental debridement, important washing with H2O2 and betadine.
Postoperatively, antibiotic treatment was administered along with proper wound dressing and daily washing with antiseptic solutions. Local healing was favourable, with granulation tissue at the level of the wound after 21 days of treatment (Figure 2), but due to the important remaining defect, a new surgery was required, covering the scrotum and perineum with a fasciocutaneous flap 20/10 cm in size, transposed from the inner face of the left thigh (Figure 3 and Figure 4).
Negligence and poor hygiene can lead to serious diseases, possibly crippling, whose treatment requires lengthy hospitalization, multiple surgeries, which significantly raise the costs.