AB185. SOH21AS226. The management of Fournier’s Gangrene in an Irish university hospital: a case series
General Poster Session

AB185. SOH21AS226. The management of Fournier’s Gangrene in an Irish university hospital: a case series

Lynda Condell, Morgan Peter McMonagle, Megan Power-Foley

Department of Surgery, University Hospital Waterford, Waterford, Ireland

Background: Necrotising fasciitis (NF) is a rare but life-threatening surgical emergency. Bacterial infection spreads rapidly along fascial planes leading to fulminant soft tissue necrosis and systemic toxicity. Fournier’s Gangrene is NF affecting the perineum or/and genitalia, typically caused by polymicrobial facultative organisms and anaerobes. Gold-standard treatment involves immediate broad-spectrum intravenous antibiotics, fluid resuscitation and aggressive surgical debridement of all necrotic tissue followed by supportive care for severe sepsis. Once suitable, delayed grafting of other reconstruction of the perineum may be performed.

Methods: A retrospective review was performed of all cases of Fournier’s Gangrene presenting to our institution over a two-year period.

Results: During the study period, five patients were treated for Fournier’s Gangrene. Patients were managed by either a consultant urologist or consultant general surgeon. Four patients were male and one was female. All five patients were obese. All patients underwent emergency surgical debridement of their perineum and required multiple subsequent procedures to ensure adequate excision and reconstruction. Four of the patients had a defunctioning stoma created. Three of the four male patients had neo-scrotum constructed for their testis while one had a resection of one of his testis. Each patient was treated with a different antibiotic regimen depending what organisms were cultured from debrided tissue. There was an 80% (n=4) survival rate. One patient died of respiratory arrest.

Conclusions: NF remains a significant surgical challenge, with a high rate of both mortality and long-term morbidity with functional and cosmetic deficits. However, with timely expert multidisciplinary team (MDT) input, outcomes can be salvaged.

Keywords: Fournier’s Gangrene; necrotising fasciitis (NF); surgical debridement; perineal infection; tissue infection


Funding: None.


Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-21-ab185
Cite this abstract as: Condell L, McMonagle MP, Power-Foley M. SOH21AS226. The management of Fournier’s Gangrene in an Irish university hospital: a case series. Mesentery Peritoneum 2021;5:AB185.

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