Fournier's gangrene: Surgical management

Introduction. - Perineoscrotal Fournier's gangrene is a rare and acute disease, with pejorative evolution and prognosis. This is an emergency situation requiring a concomitant medical and surgical management. Methods. - This article suggests making a clarification on surgical techniques of Fournier's gangrene by integrating the recent data of the literature. Results. - The immediate management requires an extensive surgical debridement associated with broad-spectrum antibiotics. After debridement, skin loss can be very damaging and difficult to repair. When general infection has been controlled, the second goal is surgery for skin coverage. The use of vacuum-assisted closure therapy is an alternative to conventional dressings. Finally, plastic surgery could be proposed to guide healing. Conclusion. - Extensive debridement, vacuum-assisted closure therapy, and plastic surgery are the keys of surgical management of Fournier's gangrene. (C) 2014 Elsevier Masson SAS. All rights reserved.