Unusual Occurrence of Inguinal Hernia in Raw Area Postdebridement for Fournier Gangrene

Abstract

ABSTRACT Fournier gangrene (FG) is an idiopathic spreading necrosis of the scrotum surrounding perineum which may even spread to anterior abdominal wall. The development and fast progression of gangrene can rapidly cause multiple organ failure and death. Because of potential complications, it is important to diagnose the disease process as early as possible. Management of the condition includes initial resuscitation, combined with broad spectrum intravenous (IV) antibiotics and aggressive debridement, followed by dressing and local management. Once the bed of the wound is prepared, the wound may be covered with split thickness grafts or testicular repositions. Fournier gangrene is rare but life-threatening disease. Nonetheless, occurrence of another surgically correctable emergency in the same patient can complicate the course of disease and alter the management strategy. The identification and management of such a condition in an open wound pose a diagnostic and therapeutic challenge. Here, we would like to describe the case, we encountered in our ward (Civil Hospital, Ahmedabad), which developed hernia postdebridement for FG. It presented as swelling in the raw area. The diagnosis was confirmed by investigations and managed with herniorrhaphy as the wound was contaminated. Daily dressing was continued for the raw area. The raw area developed healthy granulation tissue and there were no complications related to hernia surgery during the postoperative course. Patient then underwent testis reposition in the thigh pouch as well as coverage of raw area with split thickness graft. The uptake was healthy, and patient was discharged without any complication. How to cite this article Paryani J, Rathod G, Makwana R, Gadani R, Patel R. Unusual Occurrence of Inguinal Hernia in Raw Area Postdebridement for Fournier Gangrene. J Trauma Crit Care Emerg Surg 2014;3(1):33-36.