Fournier’s Gangrene의 임상적 고찰
Clinical Analysis of Fournier’s Gangrene
박중현, 박승철, 전해명, 정재희, 김원우, 오승택, 김정수, 김욱, 김응국, 장석균,
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박중현 ( Park Jung-Hyun )
가톨릭대학교 의과대학 외과학교실
박승철 ( Park Seung-Cheol )
가톨릭대학교 의과대학 외과학교실
전해명 ( Jeon Hae-Myung )
가톨릭대학교 의과대학 외과학교실
정재희 ( Chung Jae-Hee )
가톨릭대학교 의과대학 외과학교실
김원우 ( Kim Won-Woo )
가톨릭대학교 의과대학 외과학교실
오승택 ( Oh Seung-Tack )
가톨릭대학교 의과대학 외과학교실
김정수 ( Kim Jeong-Soo )
가톨릭대학교 의과대학 외과학교실
김욱 ( Kim Wook )
가톨릭대학교 의과대학 외과학교실
김응국 ( Kim Eung-Kook )
가톨릭대학교 의과대학 외과학교실
장석균 ( Chang Suk-Kyun )
가톨릭대학교 의과대학 외과학교실
KMID : 0356720000160050309
Abstract
Purpose: Fournier’s gangrene is a rapidly progressive (and aggressive), necrotizing fasciitis of the genitalia and perineum. Despite the use of broad spectrum antibiotics and surgical debridement, morbidity and mortality remain significant. The purpose of this study is to investigate and evaluate the clinical and laboratory characteristics of this disease.
Methods: We reviewed 17 cases of Fournier’s gangrene during 10 years from January, 1990 to December, 1999. We retrospectively analyzed these patients and considered several factors, which were age, sex, combined and etiologic factors, symptom and location of infection, duration of admission, operation and its complication, result of bacterial culture and sensitivity of antibiotics, morbidity and mortality.
Results: the mean age was 47.4 years with an age range of 3 to 77. The etiologies included unknown (65.7%), anorectal infection (23.5%) and hemorrhoidectomy (11.8%). The combined diseases (predisposing factors) included diabetes mellitus (52.9%), alcohol abuse, steroids or chemotherapy, liver cirrhosis and malignancy. Aggressive surgical debridement with broad spectrum antibiotics therapy was done on 16 patients, 1 patient refused operation. There were 3 colostomy cases, one orchiectomy, one suprapubic cystostomy case. The most common cultured organism was E.coli, 8 cases (53.3%). The mean hospital stay was 32.9 days. 3 patients (17.6%) were died due to sepsis and multiorgan failure.
Conclusion: Our results showed that the early recognition, aggressive debridement of devitalized tissue, antibiotic therapy, search for primary source are considered as the treatment of choice for Fournier’s gangrene.
키워드
Fournier’s gangrene
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