Persons undergoing treatment for Fournier's gangrene are faced with several serious concerns. Initially, there is the presentation of a life-threatening diagnosis by the health care team. Almost immediately after that, they must undergo a lengthy operative procedure, which will, most likely, be just the first in a series of debridement interventions. The necessity of wide debridement makes the surgery disfiguring and potentially disabling.
From the onset, patients and families should be provided with education and counseling regarding the seriousness of the illness. This education should include, at a minimum, the risk of death, the treatment involved, and potential limits of reconstruction and function following removal of necrotic tissue. Initial diagnosis is usually explained by the physician, along with a general description of required surgical intervention. However, the nurse/health care provider is in an important and unique position to educate and help prepare the patient and family to understand the nature of the disease and the recovery/ healing process involved. En couraging patient and family discussion of the difficult choices, providing support, and working toward the best possible psychosocial outcome for the patient undergoing treatment for this disease is also a crucial goal. Teaching, a skill at which nurses are known to excel, should include an explanation of the disease process, the various treatments used, the potential length of recovery, and an expectation of changes in the appearance and function of the body parts involved. If not suggested by the physician, the nurse can advise that a psychologist be involved with the patient and family to provide counseling directed at feelings of loss, body image, powerlessness, and short and long-term changes in family dynamics.
Common complications following treatment can include ongoing pain, as well as sexual dysfunction related to penile deviation, loss of sensitivity, and pain during erection (Theiss, Hofmockel, Eckert, & Frohmuller, 1996). Nurses/health care pro viders must be sensitive and aware of potential patient feelings of disturbance in body image. Patients should be encouraged to discuss their feelings about the disease, treatment, and future self-concept, as well as how they believe others will view them. Any misinformation should be corrected and communication between the patients and their significant others facilitated. Family strengths should be identified and focused toward patient support.
Urol Nurs. 2007;27(4):296-299. © 2007 Society of Urologic Nurses and Associates
Cite this: A Case of Fournier's Gangrene - Medscape - Aug 01, 2007.