Reconstruction of sequelae due to Fournier's gangrene: report of two cases

Authors

  • Víctor Manuel Bravo-Gálvez Instituto Mexicano de Seguro Social, Unidad Médica de Alta Especialidad 1, Centro Médico Nacional del Bajío, León, Guanajuato, México. https://orcid.org/0000-0002-4976-9609
  • Hedler Olaf González-Villegas Instituto Mexicano de Seguro Social, Unidad Médica de Alta Especialidad 1, Centro Médico Nacional del Bajío, León, Guanajuato, México https://orcid.org/0000-0002-9586-2302

DOI:

https://doi.org/10.48193/revistamexicanadeurologa.v80i6.648

Keywords:

Fournier´ s gangrene, Sequelae, Reconstruction, Graft

Abstract

Clinical case description: Two men, 47 and 39 years of age, with a history of type 2 diabetes mellitus, developed Fournier’s gangrene. They underwent emergency debridement, requiring 2 or more surgical toilets, and received antibiotic therapy. One patient underwent vacuum-assisted closure. Once the patients recovered, reconstructive surgery with advancement flaps and full-thickness autologous skin grafts taken from the thigh were carried out, respectively.

Relevance: Fournier’s gangrene is an infection that has a high mortality rate. It involves the soft tissues of the perineal and genital regions of immunocompromised patients, requiring aggressive surgical management that leaves important anatomic and functional sequelae. When our patients recovered, there was little evidence of the monitoring and treatment of Fournier’s gangrene sequelae.

Clinical implications: The goal of reconstructive therapy is the reincorporation of the patient into his everyday life, attempting to maintain the anatomy as normal and functional as possible.  There are still no guidelines on the best reconstruction method for Fournier’s gangrene sequelae but at present the use of grafts are considered the best measure.  

Conclusion: The use of full-thickness autologous skin grafts was beneficial in our patients. However, a review of the literature should be carried out to standardize the use of grafts and reconstructive techniques, according to the sequelae.

References

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Published

2021-01-13

Issue

Section

Clinical cases