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VAC (Vacuum Assisted Closure) treatment in Fournier's gangrene: personal experience and literature review.
- Source :
-
La Clinica terapeutica [Clin Ter] 2011; Vol. 162 (1), pp. e1-5. - Publication Year :
- 2011
-
Abstract
- Introduction: Fournier's gangrene (FG) is a rapidly developing necrotizing fasciitis that originates in genital and perineal region. The mortality rate is high and requires prompt diagnosis, antibiotic treatment and extensive necrosectomy with derivative colostomy. Vacuum Assisted Closure (VAC) is a wound care system of paramount importance in the treatment of complex wounds, including the perineum.<br />Materials and Methods: We evaluated 6 cases of FG (males, mean age: 54.6 yrs) of the last 3 years (February 2008-August 2010). All patients were diabetics. We used intravenous antibiotic treatment and early surgical debridement with colostomy, followed by immediate positioning of a VAC device (NP 125-200 mmHg). The dressing changes were done every 3-4 days. Hyperbaric oxygen therapy (HBOT) was given only to one patient. Microbiological etiology was assessed by multiple cultures to tailor the antimicrobial treatment.<br />Results: The VAC therapy reduces the number of dressings and the hospital length of stay (LOS), in agreement with the literature; in one of the cases a secondary reconstructive surgical intervention was possible. The colostomy was reversed in all patients within 3 months.<br />Conclusions: Negative pressure is a time saving device, reducing days of hospitalization, patient's discomfort and number of medications. The possibility of a early reconstructive surgery improves significantly quality of life.
- Subjects :
- Adult
Aged
Anti-Bacterial Agents therapeutic use
Colostomy
Combined Modality Therapy
Debridement
Diabetes Complications surgery
Fournier Gangrene diagnostic imaging
Fournier Gangrene drug therapy
Fournier Gangrene therapy
Humans
Hyperbaric Oxygenation
Hypertension complications
Male
Middle Aged
Obesity complications
Paraplegia complications
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Fournier Gangrene surgery
Negative-Pressure Wound Therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1972-6007
- Volume :
- 162
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- La Clinica terapeutica
- Publication Type :
- Academic Journal
- Accession number :
- 21448535