Management of Fournier's gangrene in a surgical department of Sub-Saharan Africa: A case series

Abstract

Fournier gangrene is a serious condition that affects the perineum and is characterized by necrotizing fasciitis. This study aimed to examine the management of a series of patients with Fournier's gangrene at the Saint-Louis Regional Hospital (Senegal). Fourteen patients were included: 11 males and 3 females. The hospital incidence was 7 cases per year. The mean patient age was 50 years. Half of the patients had diabetes and two were obese. The mean consultation time was 7.2 days. Lesions were located in the penile scrotal area in five cases and the scrotum in three cases. The source of infection was identified in six patients. All patients had leukocytosis, and half of them had anemia. The Quick-SOFA score was positive in three patients. The average debridement was 35.4 hours. In addition, three patients required colostomy. A transurethral tube was inserted in all patients. Additional treatments included sitz baths in 3 patients. Mortality was 14%. Fournier gangrene is a significant concern, particularly in patients with diabetes. Death was observed in patients with severe associated health conditions, and the Quick-SOFA score was useful in identifying severe patients. Sitz baths may be considered an alternative treatment option where hyperbaric oxygen is not available.