Vacuum Sealing Drainage Enhances Recovery in Severe Fournier’s Gangrene Cases: Study
China: Researchers have found in a new study that vacuum sealing drainage (VSD) can improve outcomes in Fournier’s gangrene by speeding recovery, shortening hospital stays, and reducing antibiotic use—especially in patients with high LRINEC scores or extensive infections. However, treatment should be tailored based on disease severity indicators like the Fournier’s Gangrene Severity Index (FGSI).
The findings are from a single-centre retrospective study published in BMC Surgery by Xinjian Li and colleagues from the Department of Proctology at Beijing Anorectal Hospital (Beijing Erlong Lu Hospital), Beijing, China. The research compared the clinical outcomes of VSD and conventional dressing methods in patients with Fournier’s gangrene, a rapidly progressing and potentially fatal infection that requires immediate surgical intervention.
The study assessed 104 patients treated for Fournier’s gangrene between January 2022 and December 2023. Among them, 42 underwent VSD following surgical debridement, while 62 received conventional wound dressings. Patient data, including demographics, comorbidities, infection sites, Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) scores, and antibiotic duration, were analyzed. To minimize bias, the researchers applied inverse probability of treatment weighting (IPTW) for statistical adjustment.
The key findings of the study were as follows:
- Before adjustment, patients in the VSD group had longer hospital stays and used more antibiotics compared to those receiving conventional dressings.
- After applying inverse probability of treatment weighting (IPTW) correction, the outcomes improved significantly in favour of the VSD group.
- VSD-treated patients achieved faster normalization of leukocyte counts, with recovery occurring approximately 1.8 days earlier.
- The duration of antibiotic therapy was reduced by about 2 days in the VSD group.
- The length of hospital stay was shorter by nearly 3 days among patients treated with VSD.
- Post-adjustment analysis confirmed VSD as a protective factor, showing well-balanced baseline characteristics between both treatment groups.
According to the authors, VSD promotes faster recovery by improving wound drainage and infection control, which in turn limits antibiotic use and shortens hospital stays. The benefits were more noticeable in patients with higher LRINEC scores or more extensive infections, suggesting that VSD may be particularly advantageous for severe cases. However, they emphasized that management strategies should remain individualized, taking into account overall disease severity and FGSI values.
Despite promising results, the study has limitations. Its single-centre, retrospective design makes it prone to selection bias and lacks the strength of randomized trials. Differences in surgical techniques, timing of VSD use, and surgeon preference may have affected outcomes. Moreover, the small sample size and short three-month follow-up restrict the generalizability and assessment of long-term results.
Despite these constraints, the research adds valuable evidence supporting the clinical use of VSD in managing Fournier’s gangrene. The authors call for larger, multicentre, prospective studies to confirm these results and further explore long-term outcomes. They conclude that VSD offers a meaningful improvement in clinical recovery by accelerating leukocyte normalization and reducing both antibiotic duration and hospital stay—emphasizing the potential of VSD as a valuable adjunct in the treatment of Fournier’s gangrene when tailored to patient-specific factors.
Reference:
Li, X., Zhang, Y., Xiong, F. et al. Comparison between vacuum sealing drainage (VSD) and conventional dressing for fournier’s gangrene: a single-centre retrospective study. BMC Surg 25, 481 (2025). https://doi.org/10.1186/s12893-025-03242-8
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