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Profile of patients with Fournier’s gangrene and their clinical evolution

ABSTRACT Objective: to analyze the profile of patients with Fournier’s gangrene treated in a public tertiary hospital in western Paraná State. Methods: we conducted a cross-sectional, retrospective and descriptive study of patients with Fournier’s gangrene treated between January 2012 and November 2...

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Published in:Revista do Colégio Brasileiro de Cirurgiões 2018, Vol.45 (1)
Main Authors: DOS-SANTOS, DJONEY RAFAEL, ROMAN, ULISSES LUIZ TASCA, WESTPHALEN, ANDRÉ PEREIRA, LOVISON, KELI, SPENCER NETO, FERNANDO ANTONIO C.
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Language:eng ; por
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Summary:ABSTRACT Objective: to analyze the profile of patients with Fournier’s gangrene treated in a public tertiary hospital in western Paraná State. Methods: we conducted a cross-sectional, retrospective and descriptive study of patients with Fournier’s gangrene treated between January 2012 and November 2016. Results: there were 40 patients with Fournier’s gangrene treated in the period, 29 (72.5%) men and 11 (27.5%) women. The mean age was 51.7±16.3 years. The mean time of disease progression, from the initial symptom to hospitalization, was 10.5±1.2 days. All patients had clinical signs such as pain, bulging, erythema, among others, and 38 (95%) had associated comorbidities, the most common being type 2 diabetes mellitus and systemic arterial hypertension. The majority (30 patients - 75%) had perianal abscess as the probable etiology. All patients were submitted to antibiotic therapy and surgical treatment, with a mean of 1.8±1.1 surgeries per patient. Nine (22.5%) patients died. There was a strong correlation between the presence of sepsis on admission and mortality. Conclusion: Fournier’s gangrene patients in this series had a long disease duration and a high prevalence of comorbidities, with a high mortality rate. ABSTRACT Objetivo: analisar o perfil dos pacientes com gangrena de Fournier tratados em um hospital público terciário do oeste do Paraná. Métodos: estudo transversal, retrospectivo e descritivo de pacientes portadores de gangrena de Fournier atendidos no período de janeiro de 2012 a novembro de 2016. Resultados: foram tratados 40 pacientes com gangrena de Fournier no período: 29 (72,5%) homens e 11 (27,5%) mulheres. A média de idade foi de 51,7±16,3 anos. A média de tempo de evolução da doença, do sintoma inicial até a internação, foi de 10,5±1,2 dias. Todos os pacientes apresentaram algum sinal clínico como dor, abaulamento, eritema, entre outros, e 38 (95%) tinham comorbidades associadas, sendo as mais comuns diabetes mellitus tipo 2 e hipertensão arterial sistêmica. A maioria (30 pacientes -75%) apresentava como etiologia provável abscesso perianal. Todos os pacientes foram submetidos à antibioticoterapia e tratamento cirúrgico com média de 1,8±1,1 cirurgias por paciente. Nove (22,5%) pacientes morreram. Houve forte correlação entre a presença de sepse na admissão e mortalidade. Conclusão: pacientes portadores de gangrena de Fournier, nesta casuística, apresentavam longo tempo de doença e elevada prevalência de comorbidades com alto índice de m
ISSN:0100-6991
1809-4546
1809-4546
DOI:10.1590/0100-6991e-20181430