Outcomes in Fournier's Gangrene Using Skin and Soft Tissue Sparing Flap Preservation Surgery for Wound Closure

An Alternative Approach to Wide Radical Debridement

Travis L. Perry, MD; Lindsay M. Kranker, MD; Erin E. Mobley, PA; Eileen E. Curry, MD; R. Michael Johnson, MD, MPH

Disclosures

Wounds. 2018;30(10):290-299. 

In This Article

Limitations

No clinical study is without limitations. A major limitation in this study is the lack of a control group, which limits the outcome comparison to historical controls of NSTIs in the literature. The different innovations over time and different resource allocation between differing institutions make any statistical comparison impossible. In addition, this study did not evaluate the financial impact of a reduced LOS, the use of topical antibiotics and NPWT versus wet-to-dry dressings. It is possible that there is an overall cost savings to this approach, but further analysis is required. The inability to maintain a seal for NPWT may lead to the impediment of assisted closure using this device. Wounds in which significant gluteal and perianal skin necrosis are present may lead to the inability to achieve wound closure without surgical or nonsurgical fecal diversion. Limitations also include a small sample size and single institution design; however, considering the rarity of this disorder, the sample size is considered representative.

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