Fournier gangrene is an acute necrotic infection of the scrotum; penis; or perineum.

It
is characterized by scrotum pain and redness with rapid progression to gangrene and
sloughing of tissue.

Fournier’s gangrene involves an infection in the scrotum (which includes the testicles),
penis, or perineum. The perineum is the area between the scrotum and anus for a man; or
the area between the anus and vulva for a woman. The dead or dying tissue in people
with this type of gangrene is often found in the genitals and can stretch to the thighs,
stomach, and chest.
 Fournier gangrene is a life-threatening urosurgical emergency characterized by a
polymicrobial infection of the perineal, genital, or perianal region that may rapidly
progress to sepsis, septic shock, fulminant multi-organ dysfunction, and death.

How Common Is It?

Fournier’s gangrene is rare. While it’s more common in men, women and children also can get
it.

The disease is most often found in men between the ages of 50 and 60. Men are 10 times more
likely than women to have Fournier’s gangrene.

Fournier’s gangrene is even rarer in children.

Causes

Fournier’s gangrene usually happens because of an infection in, or near, your genitals. Sources
of the infection can include:

 Urinary tract infections

 Bladder infections
 Hysterectomies
 Abscesses (swollen body tissue that contains pus)
 Piercings

In children, the causes can include:

 Insect bites
 Burns
 Circumcision

While not actually considered causes of Fournier’s gangrene, there are other conditions and
medications that experts believe may make you more likely to get this disease, including:

 Diabetes
 Alcohol abuse
 Trauma to the genital area
 Steroids
 Chemotherapy
 HIV
 Obesity
 Cirrhosis (a liver disease)
  A certain type of diabetes medicine called sodium-glucose cotransporter-2 (SGLT2)
inhibitor

Doctors can find the cause of Fournier’s gangrene in about 90% of the cases.

Symptoms

People with Fournier’s gangrene can have various symptoms, including:

 Fever
 Pain and swelling in the genitals or anal area
 Unpleasant odor coming from the affected skin tissue
 Crackling sound when touching the affected area
 Dehydration
 Anemia

What are the nursing management of gangrene?

 The symptomatic treatment is as follows: Infection: Serious infections are usually treated
with antibiotics. Debridement: Debridement is the surgical removal of the dead tissue that
results from gangrene. Vascular surgery: Vascular surgeries can be used to restore the
blood flow either by Angioplasty or Bypass surgery.

Treatment

You should see a doctor immediately. Treatments include:

 Antibiotics given by IV (through your veins).

 Surgery to remove the dead and dying tissue and to confirm the diagnosis.

You may also need reconstructive surgery after your infection is under control. And some people
need colostomies (for getting rid of poop) and catheters (for getting rid of pee), depending on the
area that’s affected. Some people also need hyperbaric oxygen therapy -- this means you are
given pure oxygen while in a pressurized room.

You may also get a tetanus shot if you have an injury.

Triple antibiotic combined with radical debridement is the mainstay of treatment. There have
been m moany advances in management of Fournier gangrene including use of vaccum assisted
closure and hyperbaric oxygen therapy. With introduction of newer devices like Flexi-Seal, fecal
diversion can be done, avoiding colostomy.

Can You Prevent It?

There are some steps you can take to lower your chances of getting Fournier’s gangrene:

1. If you have diabetes, check your genitals and surrounding areas for wounds or signs of
infection, as well as for swelling or drainage.
2. If you are obese or even just overweight, try to lose some weight.
3. If you smoke or chew tobacco, stop. Tobacco use can damage blood vessels.
4. To lower your risk of infection, wash open wounds with soap and water and keep them
dry and clean until they heal.

Left untreated, gangrene may progress to a serious blood infection called sepsis. Sepsis
may cause complications including organ failure, extremely low blood pressure,
changes in mental status, shock and death