The Role of Colostomy and Reconstructive Surgery in Managing Fournier's Gangrene: A Review

What is it about?

The use of bowel diversion and reconstructive surgeries in managing Fournier's gangrene (FG) is case dependent and requires close collaboration between urologists, colorectal and plastic surgery teams. Existing evidence suggests that bowel diversion and colostomy formation can reduce the need for further debridement, shorten the time to wound healing, and facilitate skin graft or flap uptake in patients with FG. However, the psychological impact of a stoma was not a major concern for patients. Large and deep defects seem to benefit from skin grafts or flaps. The use of bowel diversion and reconstructive surgeries in managing FG is case dependent, and it is important to have close discussions with colorectal and plastic surgery teams when managing FG.

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Why is it important?

The treatment of Fournier's gangrene (FG) is complex and requires a multidisciplinary approach. This research emphasizes the importance of a collaborative approach between urologists, colorectal surgeons, and plastic surgeons to manage FG effectively. Bowel diversion and reconstructive surgeries play a crucial role in managing FG, and their use is case-dependent. This research provides important insights into the role of bowel diversion and reconstructive surgeries in managing FG and facilitating multidisciplinary collaboration between medical teams. Key Takeaways: 1. Bowel diversion and colostomy formation can reduce the need for further debridement, shorten the time to wound healing, and facilitate skin graft or flap uptake in patients with FG. 2. Stoma formation carries a risk of perioperative complications and may prolong the length of hospital stay. 3. Large and deep defects in FG benefit from skin grafts or flaps. 4. Burial of testicles in thigh pockets is not recommended due to concerns regarding thermoregulation and psychological impact on patients. 5. A multidisciplinary input is paramount for key decision-making in FG treatment, such as choosing wound closure techniques and whether to create a diverting colostomy as an adjunct method for wound healing.