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allied
academies
Joint Event
February 21-22, 2019 | Paris, France
Microbiology & Applied
Microbiology
2
nd
International Conference on
World Congress on
Wound Care, Tissue Repair
and Regenerative Medicine
&
Journal of Trauma and Critical Care | Volume 3
The synergy of different negative pressure wound therapy fillers combined with surgery to treat
Fournier’s gangrene disease
Parisi Andrea, E A Baglioni, I Isaija, A Gianfala, L Spaziante, A Russo, P Carbone
and
MA Bocchiotti
University of Turin, Italy
F
ournier’s gangrene (FG) is a soft tissue acute necrotizing
bacterial infection of perineal and male genitalia, rapidly
progressive, with a mortality rate between 10-83%. We
present a case of diabetic and overweight 65 year male with FG
involving the left side of scrotum, perineum, lower abdominal
wall, inguinal region and left hip.
Due to the septic status at the arrival, the patient has been
undergone to several massive surgical debridement removing
necrotic tissue and protective colostomy, then supportive
therapies and systemic antibiotic therapy were administered.
A left side abdominal wound and the perineal one, with the
testis exposed, were still open. We applied on these latter
ones the a negative pressure wound therapy (NPWT) with
continous wound cleaning (30 minutes every 4 hours) with
polyhexamethylene biguanide (PHMB) solution for 15 days. Due
to the wounds improvement, a NPWT dressing at -175mmHg
with poliurethan foam filler was applied above a layer of gauze
with PHMB on abdominal and perineal wounds and with a
polialcoholic foam filler with low adesivity to cover the testis.
As wound bed preparation, the wound dressing was changed
twice a week for 8 week The perineal and scrotal wounds were
then sutured and dressed with incisional NPWT, together with
NPWT above abdominal wound, in order to remove excess
exudate and promote the suture edges healing. The abdominal
wound was covered using an autologous dermal-epidermal
graft in addiction to NPWT with polialcoholic filler foam to
ensure the engraftment process. After 90 days, the patient
healed and was discharged. The multimodality and synergic
approach by massive debridement, the NPWT with different
fillers depending on the wound needs and anatomic region,
the supportive therapy, together with the systemic antibiotic
therapy and the nutritional implementation have saved the
patient life with minimal discomfort and acceptable aestethic
outcomes.
e:
andrea.parisi88@gmail.comJ Trauma Crit Care, Volume 3
DOI: 10.4066/2591-7358-C1-003