Open AccessFournier’s Gangrene: the Criteria for Diagnosis, Prognostic Factors, Complications and Mortality
Author(s) -
А В Прохоров,
Прохоров Андрей Владимирович
Publication year - 2017
Publication title -
vestnik èksperimentalʹnoj i kliničeskoj hirurgii
Language(s) - English
Resource type - Journals
eISSN - 2409-143X
pISSN - 2070-478X
DOI - 10.18499/2070-478x-2017-10-2-154-164
Subject(s) - medicine , sepsis , gangrene , fournier gangrene , anaerobic infection , differential diagnosis , surgery , intensive care medicine , fasciitis , emergency medicine , anaerobic exercise , physical therapy , pathology , necrotising fasciitis
The early diagnosis, prognosis, complications and mortality Fournier’s gangrene (FG) are discussed. The terms pre-hospital period with FG is amount of 8.0 ± 5.2 days. Cases of misdiagnosis are observed in 70% in the early stages of FG due to nonspecific clinical and laboratory picture, lack of awareness and alertness of doctors. Early diagnosis of FG is based on clinical and laboratory data of the picture. In order to timely diagnosis of FG is used scale laboratory indicators of necrotizing fasciitis (LRINEC), allowing suspect FG in doubtful cases. In diagnostically unclear cases FG used radiation methods. At the slightest suspicion on the FG made explorative operation, including express biopsy of soft tissues. The differential diagnosis is carried out in the early stages of FG with acute diseases anogenital region and is rarely used. As a prognostic criteria discussed the patient's age, the presence and nature of comorbid diseases, severity of the condition, the hospital admission dates, duration of preoperative period, necrosis area, metabolic parameters, the amount of remedial necrectomy, antibiotic regimen, hyperbaric oxygen therapy. For the systematic evaluation of the severity of the patient's condition and prognosis use different scoring systems. Many of the proposed prognostic criteria are controversial. The favorable prognosis in FG is entirely dependent on early diagnosis and timing of emergency surgery. Sepsis and its complications are the main causes of deaths. Mortality in the FG has been a steady downward trend, and is 22.3 ± 8.8%. Prevention of the FG is a timely treatment of infectious and inflammatory diseases of the urinary organs and their complications.