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>Journals >Cirujano General >Year 2004, Issue 1

Acuña PR, Cervantes GM, González CA, Ibarias ULA, Aguilar VMA, Aldama MC, Téllez RF
Fournier’s gangrene, secondary to a rectal trauma, treated with surgery and hyperbaric chamber. Report of one patient
Cir Gen 2004; 26 (1)

Language: Español
References: 16
Page: 45-48
PDF: 4. Kb.

Full text


Objective: To describe a case with Fournier’s gangrene secondary to rectal trauma.
Setting: Third level health care hospital.
Case description: Man of 63 years of age with rectal trauma secondary to aggression with a base-ball bat, who was admitted to the hospital 25 days after the aggression with pain in the perineal region, increase in the perineum volume, skin necrosis, fatty tissue, and purulent secretion. He was subjected to terminal colostomy with Hartman type distal closure, extensive debridement and surgical lavage, as well as five daily sessions in the hyperbaric chamber for 20 days. The patient evolved satisfactorily with metabolic control, progressive decrease of the secretion, adequate granulation of the tissue, and progressive covering of the perineum skin until covering completely the defect. He was discharged 24 days after.
Conclusion: The adjuvant treatment in the hyperbaric chamber increases oxygen diffusion by hemoglobin directly diluted in the plasma, which increases its concentration at the sites of anaerobiosis, improves leukocytes’ bactericide actions; besides, its per se effect on anaerobic bacteria, increases neo-vascularization and tissue granulation, controlling infection and stimulation early cicatrization. The hyperbaric chamber should be a tool of the general surgeon to be applied in selected cases.

Key words: Perineum, perineal gangrene, rectal trauma, hyperbaric chamber.


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>Journals >Cirujano General >Year 2004, Issue 1

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