Fournier’s Gangrene: 5 Patients Treated with Hyperbaric Oxygen

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Abstract
The classic syndrome of Fournier''s gangrene was observed in 5 men with involvement of the external genitals and lower abdominal wall. Mixed flora of anaerobic and aerobic microorganisms were grown, and extensive necrosis of the skin and subcutaneous gas were present in all patients. Soon after hospitalization all 5 patients were treated by excision of all necrotic and undermined tissue, i.v. broad-spectrum antibiotics and hyperbaric O2 administered at 3 atm pressure. One patient died of septic shock without any response to the therapy. The infection subsided shortly after the hyperbaric oxygen was instituted in the remaining 4 patients, who were cured. The treatment of Fournier''s gangrene should be limited to centers capable of administering hyperbaric O2 therapy. Hyperbaric oxygenation may not be necessary for successful treatment but evidence suggests a beneficial effect of such therapy for nonclostridial gas gangrene.