Features of the Clinical Course of Fournier's Disease and the Results of an Improved Method of Surgical Treatment

Fournier's disease was considered a rare pathology, but over the past 10 years this trend has changed, the number of such patients has increased significantly. Mortality with untimely treatment reaches 90% due to the development of septic shock and multiple organ dysfunction syndrome. Purpose of the study. Study the results of BF treatment depending on the timing of admission and the method of surgical treatment. Methods. The results of treatment of 31 patients with BF who were admitted to the Republican Department of Surgical Infection, Makhachkala City Clinical Hospital were analyzed. The main group included 18 (58%), in the control group 13 (42%) The terms of admission of patients to the hospital from the onset of the disease were: during the first day from the onset of the disease, 7 (22.6%) patients were admitted (3 in the main and 4 in the control group); on the second day, 13 (41.95%) were admitted - (7 in the main and 6 control); 8 (32.3%) were admitted within 3 to 4 days (5 in the main and 3 in the control group). Upon admission, patients of both groups were hospitalized in the intensive care unit, where they received complex treatment, which included: antibacterial therapy, protein solutions, correction of electrolyte disorders and sugar, full parenteral and enteral nutrition, anticoagulant and detoxification therapy, proton pump preparations to protect the stomach from stress ulcers, vasopressor support-noradrenaline, if necessary, blood transfusion. In the main group, emergency surgical treatment consisted of a wide autopsy throughout the spread of the process, with the formation of a single open wound. In the control group, surgical treatment consisted of the use of separate incisions, along the spread, with their wide opening. Statistical data processing was performed using Student's t-test and χ 2 ; correlation analysis - using the r criterion. Data processing is performed using Statistic 6.0. Results . The use of the developed surgical treatment method in the integrated treatment of Fournier's disease significantly reduced the number of repeated interventions and reduced the mortality rate to 5.6%, compared with the control group, where the mortality rate was 38.4%. The highest mortality was noted in patients admitted late from the onset of the disease. Conclusion . Wide autopsy throughout the spread of the process with the formation of a single wound in Fournier's disease can significantly improve treatment results and reduce mortality.