Fournier's gangrene in a single-center experience: a retrospective analysis of 23 cases

Purpose: This study aims to retrospectively evaluate the outcomes of patients diagnosed with Fournier’s gangrene (FG) treated and followed up in our clinic and to contribute to the literature. Materials and methods: We retrospectively analyzed the data of 23 patients diagnosed with Fournier's gangrene and treated in our clinic between October 2015 and October 2024. Parameters such as age, gender, localization of gangrene, mortality status, comorbidities, laboratory findings, treatment methods, and microbiological results were evaluated. Results: Of the 23 patients, 18 (78.3%) were male, and 5 (21.7%) were female, with a mean age of 56.1 years (range: 26-78). The average hospital stay was 16.2 days (range: 2-35), and 11 (47%) patients required intensive care. Mortality occurred in 4 (17.4%) patients. Comorbidities were present in 17 (74%) patients, while 6 (26%) had no comorbid conditions. Hypertension (HT) and diabetes mellitus (DM) were the most common comorbidities, each seen in 9 (52.9%) patients. The mean C-reactive protein (CRP) level was 203.3 mg/L. Gangrene was predominantly observed in the perianal region in 9 (39.13%) patients, the perineal region in 8 (34.79%) patients, and the scrotal region in 3 (13.04%) patients. Microbiological analysis revealed polymicrobial flora, with Escherichia coli being the most common pathogen (30.4%). All patients underwent surgical debridement and were treated with appropriate antibiotic therapy and regular wound care. Colostomy was performed in 14 (60.8%) patients, while vacuum-assisted closure (VAC) therapy was applied to 6 (26.8%). Conclusion: Fournier's gangrene is a rapidly progressing and potentially fatal infectious disease if not diagnosed and treated promptly. A multidisciplinary approach is essential to achieving successful outcomes in its management.