The Role of Colostomy in Management of Fournier’s Gangrene

Study Objective: The colostomy is not used systematically for the treatment of Fournier’s gangrene. Through our study, we compared two groups of patients who had faecal diversion and those how did not .we tried to get the advantages of this method and his impact on wound healing and duration of hospitalization

Patients and Methods: This is a 14-years retrospective study from 1st January 2005 to 31st December 2018. We collected 86 cases of Fournier's gangrenes, of which 30 patients benefited from a derivative colostomy, done by the same surgical team. We divided the two groups by aetiology and morbidly-mortality.

Results: In the group with colostomy, prevalent disease was perianal suppurations with the presence of risk factors in75% of cases such as diabetes, immunosuppressive therapy or patients age over 70 years old .While these factors are found only in 52% of the other group. The average days of hospital stay in the group with colostomy was 25 days and 32 in the other group, 67% of patients had a colostomy with hyperbaric oxygen therapy against 70% in the other group. Mortality was 30% in first group with colostomy, an 12.5% in the second one, the overall mortality was19% globally in the two groups.

Conclusions: In our series only 35% benefited from a colostomy: Patient with major deterioration and the presence of others diseases. But overall mortality in our series is comparable to that of teams practicing colostomy systematically.