Application of U-shaped stent in Fournier's gangrene / 临床外科杂志

ABSTRACT

Objective To study the management of Fournier's gangrene.Methods Data of 9 patients were reviewed retrospectively and were discussed according to the treatment,and outcome.U-shaped stents with poly hole and two-end drainage were used in 4 cases in whom the infection was spread along the penis,into the scrotum,up to the abdominal wall and into the perineum.Results We have treated 9 cases in the last 21 years.The patients received surgical treatment including incisions,aggressive debridement,drainage,irrigation,and antibiotic therapy.Left uncovered,the testes were protected in either a thigh or abdominal wall pouch and back in the scrotum resconstructed later with a myocutaneous medial thigh flap.When U-shaped stents was used,redunant debriding was no more necessary.The temperature and hemogram regain quickly,and the average hospitalization days decreased to 14 days.Conclusions Aggressive debridement and broad-spectrum antibiotics remain the hallmarks of treatment.Orchidectomy was erroneously part of the treatment of Fournier's gangrene.The remarkable draining effect of U-shaped stents could promote tissue healing.