Emergency management and it’s effect on clinical profile of Fournier’s gangrene in patients presenting at a rural setup


  • Tausif Kamal Syed Departament of surgery, Al-Ameen medical college, Vijaypura, Karnataka, India
  • Dilip K. Apturkar Departament of Surgery, Pravara Rural medical college, Loni, Ahmednagar, India
  • K. N. Dandekar Departament of Surgery, Pravara Rural medical college, Loni, Ahmednagar, India




Fournier’s gangrene, Index, Fournier profile, Fournier gangrene severity index, Necrotising fascitis


Background: Fournier’s gangrene (FG) is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum, leading to soft-tissue necrosis. Despite antibiotics and aggressive debridement, the mortality rate of FG remains high. This study describes our experiences in the management of FG and identifies prognostic factors.

Methods: It is a descriptive prospective study in 71 patients with FG treated at Pravara Rural Medical College and Hospital, Loni, who presented between September 2013 and September 2015.

Results: In the present series of 71 patients, 57% were between 50-70 yrs. UTI and alcohol consumption being most common co-morbid conditions and scrotal abscess (53.52%) being the most common presentation. Serum creatinine (p value 0.0008), total leucocyte count at presentation (p value 0.004) had a significant association with duration of recovery. The mean duration of stay was 16.08±3.28 days with a median of 15 days. The Fournier gangrene severity index score calculated was <9 in 59.15% of patients, and >9 in the remaining ≈40% with a mean of 8.309±3.49. A single mortality was recorded during our study.

Conclusions: Serum creatinine and total leucocyte count at presentation could play a pivotal role in not only initial emergency management but also as factors for monitoring the progress of treatment.


Fournier JA. Gangrene foudroyante de la verge. Semin Med. 1883;3:345.

Mallikarjuna MN, Vijayakumar A, Patil VS, Shivswamy BS. Fournier’s gangrene: current practices. ISRN Surg. 2012;2012.

Clayton MD, Fowler JJ, Sharifi RO, Pearl RK. Causes, presentation and survival of fifty-seven patients with necrotizing fasciitis of the male genitalia. Surgery, Gynecol Obstetr. 1990;170(1):49-55.

Thwaini A, Khan A, Malik A, Cherian J, Barua J, Shergill I, Mammen K. Fournier’s gangrene and its emergency management. Postgraduate Med J. 2006;82(970):516-9.

Laor E, Palmer LS, Tolia BM, Reid RE, Winter HI. Outcome prediction in patients with Fournier's gangrene. J Urol. 1995;154(1):89-92.

Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg. 2000;87(6):718-28.

Luján Marco S, Budía A, Di Capua C, Broseta E, Cruz FJ. Evaluation of a severity score to predict the prognosis of Fournier’s gangrene. BJU Intern. 2010;106(3):373-6.

Benjelloun EB, Souiki T, Yakla N, Ousadden A, Mazaz K, Louchi A, Kanjaa N, Taleb KA. Fournier’s gangrene: our experience with 50 patients and analysis of factors affecting mortality. World J Emergency Surg. 2013;8(1):13.

Yeniyol CO, Suelozgen T, Arslan M, Ayder AR. Fournier's gangrene: experience with 25 patients and use of Fournier's gangrene severity index score. Urol. 2004;64(2):218-22.

Patrick Spirnak J, Resnick MI, Hampel N, Persky L. Fournier’s gangrene: report of 20 patients. J Urol. 1984;131(2):289-91.

Tuncel A, Aydin O, Tekdogan U, Nalcacioglu V, Capar Y, et al. Fournier’s gangrene: three years of experience with 20 patients and validity of the Fournier’s gangrene severity index score. European urol. 2006;50(4):838-43.

Corcoran AT, Smaldone MC, Gibbons EP, Walsh TJ, Davies BJ. Validation of the Fournier's gangrene severity index in a large contemporary series. J Urol. 2008;180(3):944-8.

Kabay S, Yucel M, Yaylak F, Algin MC, Hacioglu A, Kabay B, et al. The clinical features of Fournier’s gangrene and the predictivity of the Fournier’s Gangrene Severity Index on the outcomes. Intern Urol Nephrol. 2008;40(4):997-1004.

Roghmann F, von Bodman C, Löppenberg B, Hinkel A, Palisaar J, Noldus J. Is there a need for the Fournier's gangrene severity index? Comparison of scoring systems for outcome prediction in patients with Fournier's gangrene. BJU Intern. 2012;110(9):1359-65.

Verma S, Sayana A, Kala S, Rai S. Evaluation of the utility of the Fournier's gangrene severity index in the management of Fournier's gangrene in North India: A multicentre retrospective study. J Cutaneous Aesthetic Surg. 2012;5(4):273.






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