Hyperbaric oxygen therapy with early reposition of testis in fournier’s gangrene: case report and brief review

Background: Founrier’s Gangrene (FG), an infective necrotizing fasciitis affecting crotum and perineal region, requires extensive debridement, usually it takes a very long duration for wound healing and scrotal reconstruction and reposition of testes. We are presenting a case report with review of literature, where we used HBOT in immediate postoperative period in an operated case of FG which promoted wound healing and allowed us early reposition of testes and reduced overall duration of hospital stay About The Case A 46-yr-old male driver was admitted with FG and deranged coagulation profile. On admission his surgical debridement was done. As vacuum dressing was not possible due anatomical reasons like size, site and extent of the wound; daily Hyperbaric Oxygen Therapy (HBOT) was done for five days. During this period healing of wound, slough disappearance and development of granulation tissue was monitored. Wound became healthy but swab taken from floor of ulcer grown resistant pseudomonas and klebsiella which required tow weeks of antibiotic treatment. His testicular reposition and scrotal reconstruction was done on 35th day of primary surgery and he was discharged on 48th day of admission in the hospital. To our opinion HBOT has helped to do early reposition in this case. We have done search of articles on FG using Google, Pubmed and Medline data search. We are presenting report of our case and review of literature. Conclusions: HBOT in immediate postoperative period promots wound healing and can be used do early reposition of testes. It can reduce overall duration of hospital stay. HBOT has role in treatment of Fornier’s gangrene. Further multicentric systematic studies are required to analyse exact role of HBOT in FG.