ENGİN KAYA, Sercan YILMAZ, Turgay EBİLOĞLU, Kubra Ozgok KANGAL, SELAHATTİN BEDİR, MURAT ZOR

Fournier gangreni tedavisinde çok basamaklı yaklaşım: Seri cerrahi debridman, koruyucu kolostomi, vakum yardımlı kapatma ve hiperbarik oksijen tedavisi

Fournier gangreni (FG) genital, perineal ve perianal bölgenin progresif ve yüksek mortalite oranlarına sahip nekrotizan fasiitidir ve erken tanı ve geniş cerrahi debridman da hastalığın tedavisindeki en önemli basamaktır. Bizde iki olguluk bu çalışmamızda, FG tedavisinde uyguladığımız seri cerrahi debridman, koruyucu kolostomi, vakum yardımlı kapatma (VAC) ve hiperbarik oksijen tedavisini içeren çok basamaklı tedavi yaklaşımımızı sunduk.

A multistep approach in fournier's gangrene management: Serial surgical debridement, protective colostomy, vacuum assisted closure therapy and hyperbaric oxygen treatment

Fournier' gangrene is a progressive and highly mortal necrotizing fasciitis of the genital, perineal and perianal region. The most important step of the treatment includes early diagnosis and surgical debridement. In this two case report we aimed to discuss our multistep treatment approach in Fournier's gangrene including serial surgical debridement, protective colostomy, vacuum assisted closure (VAC) and hyperbaric oxygen treatment.

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1. Chennamsetty A, Khourdaji I, Burks F, Killinger KA. Contemporary diagnosis and management of Fournier's gangrene. Ther Adv Urol 2015;7:203-15.
2. Sökmen S. Fournier Gangreni. ANKEM Derg 2012;26:331- 336.
3. Flanigan RC, Kursh ED, McDougal WS, Persky L. Synergistic gangrene of the scrotum and penis secondary to colorectal disease. J Urol 1978;119:369-71.
4. Uppot RN, Levy HM, Patel PH. Case 54: Fournier gangrene. Radiology 2003;226:115-7.
5. Safioleas M, Stamatakos M, Mouzopoulos G, Diab A, Kontzoglou K, Papachristodoulou A. Fournier's gangrene: exists and it is still lethal. Int Urol Nephrol 2006;38:653-7.
6. Pastore AL, Palleschi G, Ripoli A, Silvestri L, Leto A, Autieri D, Maggioni C, Moschese D, Petrozza V, Carbone A. A multistep approach to manage Fournier's gangrene in a patient with unknown type II diabetes: surgery, hyperbaric oxygen, and vacuum-assisted closure therapy: a case report. J Med Case Rep 2013;3;7:1.
7. Vindigni V, Scarpa C, Venezia ED, Bassetto F. Fournier's Gangrene and Negative Pressure Wound Therapy: A Case Report. Wounds 2016;28:E41-E43.
8. Jallali N, Withey S, Butler PE. Hyperbaric oxygen as adjuvant therapy in the management of necrotizing fasciitis. Am J Surg 2005;189:462-6.
9. Oymacı E, Coşkun A, Yakan S, Erkan N, Uçar AD, Yıldırım M. Evaluation of factors affecting mortality in Fournier's Gangrene: Retrospective clinical study of sixteen cases. Ulusal Cer Derg 2014; 30: 85-89.
10. Olsofka JN, Carrillo EH, Spain DA, Polk Jr HC. The continuing challenge of fournier's gangrene in the 1990s. Am Surg 1999;65:1156-9.
11. Bronder CS, Cowey A, Hill J. Delayed stoma formation in Fournier's Gangrene. Colorectal Dis 2004;6:518-20.
12. Morpurgo E, Galandiuk S. Fournier's gangrene. Surg Clin North Am 2002;82:1213-24.
13. Yılmazlar T. Fournier Gangreni: Sinsi, Öldürücü, Ancak Tedavi Edilebilir Hastalık. Kolon Rektum Hast Derg 2012;22:45-49.