Fournier's gangrene

Therapeutic impact of hyperbaric oxygen

Robert S. Hollabaugh, Roger R. Dmochowski, William Hickerson, Clair E. Cox

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Many controversial issues exist surrounding the disease pathogenesis and optimal management of Fournier's gangrene. In Fournier's original descriptions, the disease arose in healthy subjects without an obvious cause. Most contemporary studies, however, are able to identify definite urologic or colorectal etiologies in a majority of cases. To investigate disease presentation, treatment modalities, and overall mortality, a retrospective analysis of Fournier's gangrene from a single institution is presented. Since 1990, 26 cases of Fournier's gangrene have been diagnosed at the University of Tennessee. An evaluation of intercurrent disease revealed that 38 percent of the patients had diabetes mellitus, 35 percent manifested ethanol abuse, and 12 percent were systemically immunosuppressed. Fifteen patients (58 percent) presented with identifiable etiologies for their disease: 31 percent (8) urethral disease or trauma, 19 percent (5) colorectal disease, and 8 percent (2) penile prostheses. Management in all cases involved prompt surgical debridement with initiation of broad-spectrum antibiotics. Multiple debridements, orchiectomy, urinary diversion, and fecal diversion were performed as clinically indicated. Fourteen patients received hyperbaric oxygen as adjuvant therapy. Statistically significant results were noted with mortality rates of 7 percent in the group receiving hyper- baric oxygen (n = 14) versus 42 percent in the group not receiving hyperbaric oxygen (n = 12). Overall mortality was 23 percent. Controversy still surrounds disease pathogenesis in Fournier's gangrene, particularly in regard to etiology. Our study corroborates current trends in that a clear focus of origin was identified in a majority of the cases. Although a grim prognosis usually accompanies the diagnosis, this study shows significant improvement combining traditional surgical and antibiotic regimens with hyperbaric oxygen therapy.

Original languageEnglish (US)
Pages (from-to)94-100
Number of pages7
JournalPlastic and Reconstructive Surgery
Volume101
Issue number1
DOIs
StatePublished - Jan 1 1998

Fingerprint

Fournier Gangrene
Oxygen
Debridement
Therapeutics
Mortality
Urethral Diseases
Penile Prosthesis
Anti-Bacterial Agents
Hyperbaric Oxygenation
Urinary Diversion
Orchiectomy
Diabetes Mellitus
Healthy Volunteers
Ethanol
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Fournier's gangrene : Therapeutic impact of hyperbaric oxygen. / Hollabaugh, Robert S.; Dmochowski, Roger R.; Hickerson, William; Cox, Clair E.

In: Plastic and Reconstructive Surgery, Vol. 101, No. 1, 01.01.1998, p. 94-100.

Research output: Contribution to journalArticle

Hollabaugh, Robert S. ; Dmochowski, Roger R. ; Hickerson, William ; Cox, Clair E. / Fournier's gangrene : Therapeutic impact of hyperbaric oxygen. In: Plastic and Reconstructive Surgery. 1998 ; Vol. 101, No. 1. pp. 94-100.
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