SURGICAL MANAGEMENT OF FOURNIER'S GANGRENE: CLINICAL EXPERIENCE WITH FOUR CASES TREATED AT THE SURGERY CLINIC OF THE CLINICAL HOSPITAL OF TETOVO

Ademi, Aferdita and Dika-Haxhirexha, Ferizat and Fejzuli, Blerim (2026) SURGICAL MANAGEMENT OF FOURNIER'S GANGRENE: CLINICAL EXPERIENCE WITH FOUR CASES TREATED AT THE SURGERY CLINIC OF THE CLINICAL HOSPITAL OF TETOVO. In: INTERNATIONAL CONFERENCE “FROM RESEARCH TO APPLICATION”, 20 May, 2026.

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Abstract

Introduction: Fournier's gangrene is a progressive necrotizing fasciitis of the perineal, genital, and perianal region, with high mortality potential if it is not promptly diagnosed and treated. It is characterized by the rapid spread of polymicrobial infection along the fascia, causing vascular thrombosis and necrosis of the soft tissues. Aim: To present the clinical experience of the Surgery Clinic of the Clinical Hospital of Tetovo in the diagnosis, antibiotic treatment, surgical treatment, and reconstruction of large abdominal wall defects in four patients with Fournier's gangrene. Materials and methods: This is a retrospective study including four male patients aged 38 to 62 years, treated over several years. Data were collected from operative protocols, clinical records, and laboratory and microbiological analyses. Results: Two patients on admission presented with skin necrosis in the inguinal region extending to the scrotum, while the other two patients initially presented with subcutaneous purulent collections in the lower abdominal wall, which rapidly evolved into skin necrosis. All patients underwent extensive necrectomy, which left a large abdominal wall defect without skin coverage. Laboratory analyses showed marked leukocytosis, elevated CRP values, and disturbances of several other biochemical parameters. Microbiology identified polymicrobial infection with MRSA, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus spp. Patients were treated with antibiogram-guided antibiotic therapy, regular dressing changes, VAC therapy, and definitive reconstruction with split-thickness skin autografting. Hospital stay ranged from 10 days to three weeks; all four patients were discharged healed. Conclusion: Rapid diagnosis, early and aggressive surgical debridement, broad-spectrum antibiotic therapy guided by the antibiogram, negative pressure therapy (VAC), and careful reconstruction of defects with skin autografting are the pillars of success in the management of Fournier's gangrene. Our small but homogeneous experience confirms the value of this algorithm.

Item Type: Conference or Workshop Item (Paper)
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine, Health and Life Sciences > School of Medicine
Depositing User: Unnamed user with email zshi@unite.edu.mk
Date Deposited: 23 Sep 2026 09:13
Last Modified: 23 Sep 2026 09:13
URI: http://eprints.unite.edu.mk/id/eprint/2463

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