Management of Necrotizing Soft Tissue Infections (Fournier's Gangrene) and Surgical Reconstruction of Debridement Wound Defects

Urol Clin North Am. 2022 Aug;49(3):467-478. doi: 10.1016/j.ucl.2022.04.008. Epub 2022 Jun 27.

Abstract

In this article, the authors discuss the epidemiology, pathophysiology, and mechanism of spread of necrotizing soft-tissue infections of the genitalia, including classification schemas. The authors then discuss the acute clinical management of the disease, including suggestions for ways to improve surgical debridements (such that eventual reconstructions are simpler), ways to predict disease severity using laboratory, vital sign, and physical examination findings, and suggestions for initial antimicrobial treatments. Finally, reconstructive techniques and algorithms to ensure that the reconstructive goals of coverage, function, and cosmesis are met, are discussed, including the management of postoperative complications.

Keywords: Fournier’s gangrene; Genitourinary reconstruction; Necrotizing fasciitis; Necrotizing soft tissue infection of the genitalia; Split-thickness skin graft.

Publication types

  • Review

MeSH terms

  • Debridement / methods
  • Fournier Gangrene* / complications
  • Fournier Gangrene* / diagnosis
  • Fournier Gangrene* / surgery
  • Humans
  • Male
  • Plastic Surgery Procedures* / methods
  • Postoperative Complications / surgery
  • Soft Tissue Infections* / complications
  • Soft Tissue Infections* / surgery