Manejo actual del tratamiento de la gangrena de Fournier: revisión bibliográfica

Abstract

Fournier's gangrene (FG) responds to a surgical emergency that evolves rapidly and spreads from the outermost layers to the innermost layers of fascia, extending to the genitourinary, perineal or perianal area, anterior abdominal wall and affecting vital organs. The incidence is about 1.6 per 100,000 men, which indicates that men are more likely than women to experience this condition, with a ratio of 10:1; on average, it occurs in adults approximately 30 to 60 years of age. However, it can affect all ages and genders. In the physical examination at the beginning of the preclinical it presents with inflammatory signs of mild intensity such as: flushing, heat, surrounding edema at the level of the perianal region, this begins with a black spot that is called Brodie's sign, but often as the clinic progresses, it is accompanied by intense pain and hypersensitivity in the genitals, small areas of devitalized tissue are observed causing a necrotizing fasciitis, purulent exudate, foul odor, crepitus. To produce a scientific article that provides information on the current management of Fournier's gangrene treatment with easy access and comprehension, both for the general public and health personnel. A retrospective, descriptive study article was developed, which included a compilation and systematic review of scientific journals updated in the last 5 years, guided by databases and high impact medical journals in English and Spanish. A bibliographic review article was carried out with high impact on the current management of the treatment, based on studies of expert professionals on the subject, as well as thanks to the latest research, it was possible to get to know the alternative methods to have good aesthetic results in the areas affected by GF. The fatal condition known as Fournier's gangrene should be treated as a surgical emergency. Current recommendations indicate the use of negative pressure therapy, hyperbaric oxygen therapy, for wound closure the use of skin grafts or flap, and even mentioned the use of intravenous immunoglobulins and therapeutic plasma exchange, however, the information currently available does not have results that consolidate the use of this treatment.