What are the indications for a stoma in Fournier’s gangrene?*

AIM: This study examined the indications for a stoma in patients with Fournier's gangrene and its impact on outcome. METHOD: Patients with Fournier's gangrene were retrospectively reviewed for indications for a stoma. Patients with and without a stoma were compared, based on demographics, disease severity, surgical therapy, length of hospital stay, clinical outcome and cost. RESULTS: Forty-four patients (median age 57 years, range 28-77 years) were evaluated. Eighteen had a temporary stoma and 26 did not. A stoma was 5 times more likely in males. Patients with Fournier's gangrene originating from an anorectal disorder received a stoma more often than patients with disease originating from an urogenital disorder. Clinical outcomes were similar for patients with or without a stoma. Stoma closure was associated with an extra cost of about $6650 per patient. CONCLUSION: Stoma creation in the management of Fournier's gangrene was needed for selected patients. Having a stoma did not appear to affect outcomes and resulted in a significant increase in cost of care.