Vacuum sealing drainage tied to reduced dressing changes and analgesic use after surgery in Fournier's gangrene

Vacuum sealing drainage (VSD) is widely applied in complex wound repair. The researchers aimed to compare traditional debridement and drainage and VSD in treating Fournier’s gangrene Fournier’s gangrene (FG) is a severe form of soft tissue infection that occurs in the perianal, perineal, and genital regions characterized by purulent necrosis caused by multiple types of anaerobic and aerobic microorganisms. FG causes septic shock and multiple organ failure with mortality rates ranging from 4 to 67%. Surgical debridement removes necrotic tissue and drainage of lesions facilitates rapid control of systemic infection. However, FG causes extensive infection and requires repeated debridement, which leads to enlarged surgical wounds that make subsequent wound reconstruction difficult. Data of patients surgically treated for FG were retrospectively analyzed.

Results

Of the 36 patients (men: 31, women: 5; mean age: 53.5 ± 11.3 [range: 28–74] years) included in the study, no patients died. Between-group differences regarding sex, age, BMI, time from first debridement to wound healing, number of debridements, FGSI, and shock were not statistically significant (P > 0.05). However, lesion diameter, colostomy, VAS score, dressing changes, analgesic use, length of hospital stay, and wound reconstruction method (χ2 = 5.43, P = 0.04) exhibited statistically significant differences. Tension-relieving sutures (6 vs. 21) and flap transfer (4 vs. 2) were applied in Groups I and II, respectively.

VSD can reduce postoperative dressing changes and analgesic use, and shrunk the wound area, thereby reducing flap transfer in wound reconstruction.

Reference:

Chen, Jh., Li, Yb., Li, Dg. et al. Vacuum sealing drainage to treat Fournier’s gangrene. BMC Surg 23, 211 (2023).

https://doi.org/10.1186/s12893-023-02109-0

Keywords:

Vacuum, sealing, drainage, linked, reduced, dressing, changes, analgesic, use, after, surgery, Fournier’s gangrene, BMC Surgery