Fournier gangrene – an example of multidisciplinary cooperation

Overview

Fournier’s gangrene represents a rare, but very serious and life-threatening inflammatory disease that is characterized as a necrotizing infection affecting deep layers of soft tissue in the area of the external genitalia, perineum and perianal area. An early diagnosis contributes to the improvement of the treatment results and the overall prognosis of the patient. Primarily based on a complete history and physical examination, the diagnosis results are the results of laboratory tests, imaging methods are also used to clarify the diagnosis. Microbiological diagnostics and regular monitoring of laboratory values, along with monitoring of hemodynamic parameters and organ functions, should not be omitted during treatment.

In connection with this disease it is necessary to hospitalize the patient in intensive care unit and with comprehensive treatment. Therapy consists of the application of broad-spectrum antibiotics, including early surgical intervention with removal of all necrotic tissues. All measures leading to hemodynamic patient stabilization (adequate infusion hydration) and prevention of the development of multi-organ dysfunction and multi-organ failure are important. One possibility of improving the therapeutic effect is the possibility of using hyperbaric oxygen therapy.

The aim of this article is to show on the example of the patient how the theoretical knowledge of this mostly polymicrobial infection is reflected in practice and how the disease is demanding for treatment and nursing care. To find the necessary information, the authors used literary sources from freely available and licensed databases and, at the same time, experience from their own workplace - Interdisciplinary Intensive Care Unit (MOJIP) of the Havířov Hospital was compared.

Keywords:

hyperbaric oxygen therapy – Fournier’s gangrene – multiple organ failure – debridement