Epidemiology, clinical profile and management outcome of fourniers gangrene in a Tertiary Teaching Hospital

Abstract

Background: Fournier’s gangrene is a polymicrobial necrotizing fasciitis, affecting the genital, perineal and peri anal region which requires prompt and aggressive treatment. This study assessed the prevalence, clinical presentations and management outcome.
Methods: This retrospective observational study involved 39 patients with Fournier’s gangrene managed between January 2020 and December 2024. Socio-demographics, clinical features and management outcome were collated from medical records. Data was analyzed using SPSS version 27.0.
Result: Majority of patients in this study 35.9% of patients are >60 years. The mean age was 51.26+14.37 years. Prevalence of Fournier’s gangrene is 32.27/100,000. Scrotal pain and discoloration were the commonest symptoms in 38 (97.4%) patients. Gangrene involved the scrotum in 39(100%) patients,38 patients (97.4%) had perineal involvement while 24 (61.5%) had penile involvement. Alcohol consumption was the commonest predisposing factor in 19 (48.7%) participants. Amongst etiological factors, anorectal abscess occurred in 15 (44.1%), urethral stricture and epididymoorchitis occurring in 9 (26.5%) patients respectively. E. coli was commonest isolate in 19(65.5%) patients. Thirty-seven (94.9%) patients had urinary diversion while 31 (79.5%) patients had colostomy. Ceftriaxone-based antibiotic and metronidazole were the most used antibiotic combination in 37(94.9%) patients. Patients had a median of 3 debridement with hydrogen peroxide/honey dressing in 36 (92.3%). Majority of patients, 12 (35.3%) had secondary wound closure. Mean duration of admission was 39 days.
Conclusion: The prevalence of Fournier’s gangrene was 32.27/100000. Anorectal abscess being commonest cause. Aggressive wound care with hypertonic saline and honey and a multidisciplinary approach to closure of extensive wound is recommended.