Clinical experience exchange of 3 cases with Fournier's gangrene

Abstract

Fournier’s gangrene (FG), also known as necrotizing fasciitis, is a condition that affects the genitalia and perineum, resulting in the rapid development of necrosis and gangrene in infected tissues and potentially spreading to adjacent tissues, including the abdominal wall. It mainly affects males and requires prompt treatment to prevent potentially life-threatening complications. In Case 1, a 64-year-old man with type 2 diabetes was diagnosed with FG due to a scrotal skin injury after scratching his scrotal skin. The patient underwent radical debridement, treatment with broad-spectrum antibiotics, negative pressure wound treatment, and skin transplantation. In Case 2, a 79-year-old man suffered from a sebaceous cyst of the scrotum that had been scratched for seven days, resulting in black and necrotic skin of the scrotum. He was diagnosed with FG and underwent radical debridement and drainage of pus, followed by anti-infection treatment, negative pressure wound treatment, and skin transplantation. In Case 3, a 48-year-old male injured at the scrotum’s base developed swelling, pain, foul odor and pus discharge and was diagnosed with FG. The patient underwent emergency treatment, including incision and drainage of the scrotum and right lower abdominal wall abscess, as well as wound debridement. Ultimately, all three patients’ scrotal wounds returned to normal, but Case 2 was complicated by blood vessel thrombosis in both lower limbs. Early surgical debridement is a necessary intervention for FG, along with active postoperative anti-infection treatment and measures to prevent the occurrence of complications.