The effectiveness of Dakin’s solution in wound care after debridement in Fournier’s gangrene

Onur Karsli, Fatih Gokalp


Background: Fournier's gangrene (FG) is a specific form of necrotizing fasciitis seen in the external genital organs and perianal region. The basic management of Fournier's gangrene is based on critical surgical debridement. Dakin's solution (sodium hypochlorite) was originally developed to treat war wounds. In this study, we aimed to show potentially efficient of Dakin’s solution on wound healing and reoperation rate.

Methods: Thirty-three patients who were debrided due to Fournier Gangrene during 2012-2020 were included in the study. After debridement, wound care was done twice a day by dressing with a sponge moistened with Dakin's solution. Patients' age, concomitant disease, involvement site, re-debridement requirement, complications, and discharge times were recorded.

Results: The mean age of 33 male patients who participated in the study was (51-74) 63.93±15.36. Although all patients had scrotal involvement, nine patients had perineal (27.2%), 12 patients had inguinal (36.3%), four patients had a penis and pubic spread (12.1%). The mortality rate was 6%. The average length of hospital stay was 13.1±4.2 days, and the average number of debridements was 1.

Conclusions: Fournier gangrene is an important disease characterized by necrotizing infection of the genital, perineal, and perianal region and progresses with high mortality. Our mortality rate was lower than literature and we have linked our mortality rate to using Dakin's solution for wound care. Dressing with Dakin's solution is an effective and reliable method for wound care in FG patients.


Dakin’s solution, Debridement, FG, Wound

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Altunoluk B, Resim S, Efe E, Eren M, Benlioglu C, Kankilic N, et al. Fournier's Gangrene: Conventional Dressings versus Dressings with Dakin's Solution. ISRN Urol. 2012;762340.

Yücel M, Özpek A, Başak F, Kılıç A, Ünal E, Yüksekdağ S, et al. Fournier's gangrene: a retrospective analysis of 25 patients. Ulus Travma Acil Cerrahi Derg. 2017;23(5):400-4.

Ephimenko NA, Privolnee VV. Furnier's gangrene. Clin Microbiol Antimicrob Chemother. 2008;10:25-34.

Yim SU, Kim SW, Ahn JH, Cho YH, Chung H, Hwang EC. Neutrophil to lymphocyte and platelet to lymphocyte ratios are more effective than the Fournier’s gangrene severity index for predicting poor prognosis in Fournier’s gangrene. Surg Infect. 2016;17(2):217-23.

Czymek R, Schmidt A, Eckmann C. Fournier’s gangrene: vacuum-assisted closure versus conventional dressings. Am J Surg. 2009;197(2):168-76.

Haller J. Treatment of infected wounds during the Great War, 1914 to 1918. Southern Med J. 1992;85(3):303-15.

Heggers JP, Sazy JA, Stenberg BD. Bactericidal and wound-healing properties of sodium hypochlorite solutions. J Burn Care Rehab. 1991;12(5):421-4.

Radcliffe RS, Khan MA. Mortality associated with Fournier's gangrene remains unchanged over 25 years. BJU Int. 2020;125(4):610-6.

Sorensen MD, Krieger JN. Fournier’s gangrene: epidemiology and outcomes in the general US population. Urol Int. 2016;97:249-59.