Evaluation of the effect of vacuum assisted closure in the surgical management of Fournier's gangrene: A single center experience

Abstract

Fournier's gangrene is a surgical emergency arising in the perineum and genital area and is characterized as necrotizing fasciitis of the perineum and genital area. It quickly spreads between the fascial planes and causes soft tissue necrosis. Diabetes mellitus is the most prevalent predisposing factor. Early diagnosis and management are critical in the progression of the disease. Surgical debridement and wide-spectrum antibiotic therapy are the first steps in treatment. Despite advancements in diagnosis and treatment procedures and changes in critical care techniques, the disease has a death rate of 16-40%. This research compares patients operated on for Fournier's gangrene between January 2016 and January 2022, including those treated with vacuum-assisted closure technique, vs those who were not. We acquired and analyzed the data on the patients' demographic and clinical features from hospital records. The study involved 16 patients, six (38%) in Group 1 and 10 (62%) in Group 2, 11 men (68 %) and five women (32%). Swelling in the wound region was the most prevalent complaint. The most common gangrene site was the perianal region, and diabetes was the most common predisposing condition. Group 2 had a significantly shorter hospital stay (p=0.02). There was no statistically significant difference in mortality or other parameters between the groups. The main advantages of VAC therapy are that it requires fewer dressings, causes less pain, and reduces the risk of contamination. The advantages of the traditional wet dressing include its ease of use and low cost and the fact that VAC therapy promotes faster wound healing and shorter hospital stays.