Role of Hyperbaric Oxygen Therapy in management of complicated case of Fournier Gangrene to improve patient outcome

Fournier’s Gangrene is a life threatening urosurgical emergency and a synergistic gangrene of scrotum. It is a rapidly progressive and devastating form of necrotizing fasciitis of perineal, perineum and genital area associated with high mortality and morbidity. Radical surgical debridement, broad spectrum antibiotics, negative pressure wound dressings and hyperbaric oxygen therapy are considered to be the cornerstone of treatment and contribute to improved outcomes.. We present a case of 57 year old gentleman with Fournier gangrene whose case was complicated by presence of rare multiple bacteria and was successfully managed with early diagnosis, prompt measures and use of hyperbaric oxygen. Introduction Fournier’s Gangrene is acute, rapidly progressive and potentially fatal, infective necrotizing fasciitis affecting external genitalia, perineal and perianal region 2, . It is characterized by a synergistic, polymicrobial necrotizing fasciitis leading to the thrombotic occlusion of small subcutaneous vessels and the development of gangrene. The disease affects all ages, both sexes and is more common in males. The predisposing factors which may contribute to development of disease are Diabetes Mellitus (DM), alcoholism, malignancy, immunosuppression, liver or renal disease. It is associated with high mortality rates, hence urgent, aggressive and effective treatment of this condition is imperative to prevent fatal outcome.