Modern Management of Fournier’s Gangrene
Kyle J. Kopechek, Hiren V. Patel, George E. Koch
Abstract
PURPOSE OF REVIEW: This review explores new evidence in Fournier's Gangrene management, emphasizing survivorship. We highlight the shift toward skin-sparing debridement techniques, new reconstructive strategies, and highlight limited evidence on outcomes. Additionally, we examine recent evidence on diagnosis, antimicrobial therapy, adjunctive treatments, and post-operative wound care. RECENT FINDINGS: New evidence supports the feasibility of skin-sparing debridement, reducing the need for extensive reconstruction while improving primary closure rates and lowering healthcare costs. Advances in reconstructive techniques accelerate wound healing and shorten hospital stays. Optimized wound management-integrating antimicrobial solutions, negative pressure therapy, and targeted antibiotics-continues to improve recovery while minimizing morbidity and mortality. Modern Fournier's management prioritizes early recognition, tissue preservation, and early genital reconstruction. Despite advancements, gaps remain in early diagnosis and long-term outcomes after the index admission. Further research on post-reconstruction recovery is essential to refine treatment protocols and determine quality of life for affected patients.