Management and Outcome of Fournier Gangrene in a Nigeria Hospital

Abstract

Background: Fournier gangrene is a polymicrobial soft tissue infection of the genito-perineal region of the body. It is relatively rare but life-threatening. Objective: This study aimed to discuss the management and outcome of Fournier gangrene. Materials and Methods: The records of patients managed as cases of Fournier gangrene between 2020 and 2024 were retrieved from the hospital medical record department. The information collated from these files includes socio-demographic data, clinical features, modality, and treatment outcome. Descriptive analysis was done using SPSS version 23. Results: Although 15 patients were admitted and managed as Fournier gangrene, only 13 patients had complete data and were analyzed. The age distribution was between 21-80 years, with a mean of 41.1 ± 15.7 SD. All the patients were male, and all of them presented in emergency with clinical features of sepsis identified in 3 patients. The wound culture of the remaining 7 patients (53.8%) could not be retrieved. The investigated subjects ' Fournier gangrene severity index (FGSI) score showed a range of 2-12 with a mean of 7.6 ± 3.1 SD. Concerning definitive wound care, six patients (46.2%) had spontaneous wound closure due to the relatively small size of the defect. Five patients (38.5%) had primary wound closure under spinal anesthesia. The remaining two patients with FGSI scores of 9 and 11 underwent reconstructive procedures: scrotal advancement flaps + gracilis muscle flap + split-thickness skin graft. Conclusion: The average FGSI score was 7. There was no mortality. The most commonly involved part was the scrotum, while the rarest was the penis. Prompt response and adequate resuscitation are required for good outcomes, as observed in this study.