%0 Journal Article
%T Management of unusual genital lymphedema complication after Fournier¡¯s gangrene: a case report
%A Oanna Meyer Ganz
%A Rapha£¿l Gumener
%A Pascal Gervaz
%A Julien Schwartz
%A Brigitte Pittet-Cu¨¦nod
%J BMC Surgery
%D 2012
%I BioMed Central
%R 10.1186/1471-2482-12-26
%X Following perianal abscess drainage, a healthy young man presented with scrotal pain. Fournier¡¯s gangrene was diagnosed and treated with multiple surgical debridements. Tissue excision extended through the entire perineal area, base of the penile shaft, lower abdominal region, the inner thighs, and gluteal region, corresponding to 12% of the total body surface area. After serial debridements and negative pressure dressings, the defect was covered by two stages of skin grafting. Graft take was 90%. Healing was achieved without hypertrophic or retractile scar. However, chronic penile lymphedema remained and was first treated with compressive garments for 2 years. Upon failure of this conservative approach, we performed a circumcision, but only a ¡°penile lift¡± allowed a satisfactory esthetical and functional result.Fournier¡¯s gangrene can be complicated by a chronic lymphedema of the penis. Conservative treatment is likely to fail in severe cases and can be treated surgically by ¡°penile lift¡±.Fournier¡¯s gangrene is characterized by necrotizing bacterial fasciitis and infection of soft tissue and skin of the perineal region [1]. Patients with Fournier¡¯s gangrene may reveal pre-existing immune suppression of various conditions, but the disease also affects healthy individuals. Clinical onset is often insidious with minimal cutaneous lesions but typically progresses along deep fascial planes into a rapidly spreading sepsis with a potential fatal outcome in 3% to 45% of cases [2-4].In contrast to necrotizing fasciitis of the extremities, many organisms can be involved; the combination of anaerobes and aerobes are the rule rather than the exception. However, as for all sorts of necrotizing fasciitis, beta-hemolytic streptococci of group A (Streptococcus pyogenes) are the most common causative pathogens [1].Infection is rapidly invasive within hours despite antibiotic coverage, partly because antibiotic agents have difficulties to penetrate into destructed tissue with breakd
%K Fournier¡¯s gangrene
%K Penile lymphedema
%K Negative pressure wound therapy
%K Perineal reconstruction
%U http://www.biomedcentral.com/1471-2482/12/26