OUTCOME OF RECONSTRUCTIVE PROCEDURES IN FOURNIER'S GANGRENE

Objective: To determine the outcome of the reconstructive procedures utilized for the genital area wound following Fournier’s gangrene and their complications. Design & Duration: Interventional study from January 2004 to December 2006. Setting: Dept. of Surgery and Dept. of Plastic & Reconstructive Surgery at Liaquat University Hospital, Jamshoro. Patients: A total of 18 patients with Fournier’s gangrene. Methodology: Data was collected through a pre-designed proforma. Initially all the patients were managed in the Surgical ward and later on they were shifted to the Plastic Surgery & Reconstructive ward for further management. Results: Split thickness skin graft (SSG) was carried out in 12 cases (66.66%), followed by primary closure in six (33.33%) and medial thigh flaps two (11.11%) cases. Partial skin loss was seen in six (33.33%) and complete loss in one (5.55%) patient. Diabetes mellitus was the commonest co-morbidity found with Fournier’s gangrene. Conclusion: Skin grafting is an easy option with acceptable aesthetic and functional results. Primary closure of the scrotal wound by stretching and expanding is ideal when upto 1/3rd of the residual scrotal skin is available.