Negative Pressure Wound Therapy for the Treatment of Fournier's Gangrene: A Rare Case with Rectal Fistula and Systematic Review of the Literature.
J Pers Med
; 12(10)2022 Oct 11.
Article
in En
| MEDLINE
| ID: mdl-36294834
ABSTRACT
Fournier's gangrene (FG) is a Necrotizing Soft Tissue Infection (NSTI) of the perineal region characterized by high morbidity and mortality even if appropriately treated. The main treatment strategies are surgical debridement, broad-spectrum antibiotics, hyperbaric oxygen therapy, NPWT (Negative Pressure Wound Therapy), and plastic surgery reconstruction. We present the case of a 50-year-old woman with an NSTI of the abdomen, pelvis, and perineal region associated with a rectal fistula referred to our department. After surgical debridement and a diverting blow-out colostomy, an NPWT system composed of two sponges connected by a bridge through a rectal fistula was performed. Our target was to obtain healing in a lateral-to-medial direction instead of depth-to-surface to prevent the enlargement of the rectal fistula, promoting granulation tissue growth towards the rectum. This eso-endo-NPWT technique allowed for the primary suture of the perineal wounds bilaterally, simultaneously treating the rectal fistula and the perineum lesions. A systematic review of the literature underlines the spreading of NPWT and its effects.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Systematic_reviews
Language:
En
Journal:
J Pers Med
Year:
2022
Document type:
Article
Affiliation country:
Italia