Manejo de la gangrena de Fournier. Revisión sistematica

Abstract

Background: Fournier's Gangrene (FG) is a polymicrobial infection characterized by necrosis caused by anaerobic and aerobic bacteria. It most frequently manifests in the perineal, genital, and abdominal regions, especially in males, older adults, and patients with comorbidities such as diabetes mellitus or immunosuppression. Objective: To identify the most effective management of FG through a systematic review of recent scientific literature. Methods and Materials: A systematic review entitled "Management of Fournier's Gangrene. A Systematic Review" was conducted in the area of surgery. The study is descriptive, retrospective, and with a qualitative approach. The Zotero management tool was used, and the PRISMA 2020 guidelines were applied to select and analyze the included studies. Results: Twenty-five scientific articles were included, in which 100% reported a polymicrobial etiology with aerobic and anaerobic agents. The highest incidence was observed in men over 50 years of age. The most relevant risk factors were found to be diabetes mellitus and states of immunosuppression. Regarding treatment, all studies agreed on the need for early use of broad-spectrum antibiotics combined with aggressive surgical debridement as fundamental pillars to improve survival. Conclusions: Fournier's gangrene continues to represent a medical emergency with a high mortality rate. Early diagnosis and immediate surgical intervention, along with adequate antimicrobial therapy, are crucial to improve patient survival. Diabetes mellitus continues to be the most associated comorbidity and should be considered in the prevention and comprehensive management. Keywords: infection, polymicrobial, gangrene, Fournier, treatment