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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2003 June;16(3):127-30
A reconstructive approach and an unsual dressing for genital skin loss after Fournier's gangrene
Guzzetti T., Ferrario A.
Fournier's gangrene is a necrotizing fasciitis of the genitals, an often lethal pathology that has to be addressed with resuscitation techniques, immediate antibiotic therapy and aggressive surgical cleaning. The infection's onset modalities are analysed; attention is paid to the stage of demolition, the consequent reconstruction and medical therapy. Our attention then focuses on how to approach the reconstruction stage adequately, using skin grafts and the particular dressing that follows; using these 2 measures total functional and aesthetic recovery is achieved. In our patient the deep structures were saved by early antibiotic therapy, surgical cleaning and timely drainage of pus. A picture similar to real traumatic degloving was avoided (the fasciitis was blocked at an early stage). In this way we were able to choose the easiest and least invasive reconstructive procedure with resulting restitutio ad integrum. The result was guaranteed by a particular way of applying the grafts but above all by a type of dressing that assures graft ''take'' in a decidedly peculiar site. This dressing involves covering the penis with a cut syringe.