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Significance of Hyperbaric Oxygenation in the Treatment of Fournier’s Gangrene: A Comparative Study

  • Introduction: Hyperbaric oxygenation (HBO), in addition to anti-infective and surgical therapy, seems to be a key treatment point for Fournier’s gangrene. The aim of this study was to investigate the influence of HBO therapy on the outcome and prognosis of Fournier’s gangrene. Patients and Methods: In the present multicenter, retrospective observational study, we evaluated the data of approximately 62 patients diagnosed with Fournier’s gangrene between 2007 and 2017. For comparison, 2 groups were distinguished: patients without HBO therapy (group A, n = 45) and patients with HBO therapy (group B, n = 17). The analysis included sex, age, comorbidities, clinical symptoms, laboratory and microbiological data, debridement frequency, wound dressing, antibiotic use, outcome and prognosis. The statistical analysis was performed with GraphPad Prism 7® (GraphPad Software, Inc., La Jolla, USA). Results: Demographic data showed no significant differences. The laboratory parameters C-reactive protein and urea were significantly higher in group B (group B: 301.7 vs. 140.6 mg/dL; group A: 124.8 vs. 54.7 mg/dL). Sepsis criteria were fulfilled in 77.8 and 100% of the patients in groups A and B respectively. Treatment in the intensive care unit (ICU) was therefore indicated in 69% of the patients in group A and 100% of the patients in group B. The mean ICU stay was 9 and 32 days for patients in groups A and B respectively. The wound debridement frequency and hospitalization stay were significantly greater in group B (13 vs. 5 debridement and 40 vs. 22 days). Initial antibiosis was test validated in 80% of the patients in group A and 76.5% of the patients in group B. Mortality was 0% in group B and 4.4% in the group A. Conclusion: The positive influence of HBO on the treatment of Fournier’s gangrene can be estimated only from the available data. Despite poorer baseline findings with comparable risk factors, mortality was 0% in the HBO group. The analysis of a larger patient cohort is desirable to increase the significance of the results.

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Metadaten
Author: Petra Anheuser, Sandra Mühlstädt, Jennifer Kranz, Laila Schneidewind, Joachim Steffens, Paolo Fornara
URN:urn:nbn:de:gbv:9-opus-34054
DOI:https://doi.org/10.1159/000493898
ISSN:0042-1138
ISSN:1423-0399
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/30326483
Parent Title (English):Urologia Internationalis
Publisher:S. Karger AG
Place of publication:Basel, Switzerland
Document Type:Article
Language:English
Date of first Publication:2018/10/16
Release Date:2020/10/09
Tag:Fournier’s gangrene; Hyperbaric oxygenation; Necrotizing fasciitis; Necrotomy; Soft tissue infection
GND Keyword:-
Volume:101
Issue:4
First Page:467
Last Page:471
Faculties:Universitätsmedizin / Kliniken und Polikliniken für Innere Medizin
Licence (German):License LogoUrheberrechtlich geschützt