FOURNIER'S GANGRENE: RELATION OF DISEASE OUTCOMES WITH LRINEC (LABORATORY RISK INDICATOR FOR NECROTIZING FASCIITIS) SCORE AND NECROTIC AREA WIDTH

Introduction: Fournier's gangrene (FG) is a rapidly progressive, synergistic polymicrobial necrotizing fasciitis of mostly the scrotum, vulva, genital or perianal region. Aim of our study is to investigate the relation of disease outcomes with Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score and necrosis width by examining the characteristics of the patients. Materials and methods: The width of necrotic area and LRINEC score were calculated for all patients by retrospective investigation of the records of 57 subjects who had an operation due to FG in our clinics and all the information about patients were studied. Results: 52 patients (91.2%) were male and mean age was 51.3 years (range 21-74). The most common accompanying risk factor was diabetes mellitus and most commonly isolated microbial agent was Escherichia coli. LRINEC score had a positive correlation with the average duration of complaints and average number of debridements, whereas no relation with mortality was observed. Additionally, there was a significant relation between the width of necrotic area and mortality rate. Discussion: Fournier's gangrene is a rare synergistic polymicrobial infection, characteristically leads to vascular thrombosis and tissue necrosis. Mortality rate is ranging from 3 to 67%. Mortality rate of patients with a width of necrotic area >5% is significantly increased. Having more than one risk factor in patients with FG negatively affects the disease locally and systemically, and it causes a significant increase in mortality rates.