Fournier’s gangrene wounds successfully healed with High pbserum enzymes: a case report
DOI:
https://doi.org/10.33393/ao.2024.2736Keywords:
Collagenase, Enzymes, Fournier’s gangrene, recombinantAbstract
Fournier’s gangrene is an aggressive form of infective necrotizing fasciitis in the perianal and genital area. In this article we discuss the case of a 75-year-old male patient diagnosed with Fournier’s gangrene with the entire perianal region affected. Surgical washings were performed and debridement with multiple flaps were required for reconstruction. Complications in the suture wounds, cavities, and a seroma were observed after 5 weeks, and they were treated with dressings. Treatment with High pbserum recombinant enzymes was initiated after 3 weeks, to accelerate the closure of the wounds. The granulation tissue was irrigated by drip irrigation once every 3 weeks, ensuring good tissue impregnation. We observed that the epithelialization of the affected areas was achieved after the first week, and in 1 month, most of the wounds healed properly without signs of infection. High pbserum is an enzyme cocktail, composed of higher collagenase concentration, lipase, and liase. This study shows how High pbserum improves and accelerates wound healing in a patient with Fournier’s gangrene. Further investigations are needed to conclude treatment recommendations.
Downloads
References
Fournier JA. Jean-Alfred Fournier 1832-1914. Gangrène foudroyante de la verge [overwhelming gangrene]. Sem Med 1883. Dis Colon Rectum. 1988 Dec;31(12):984-8. https://doi.org/10.1007/bf02554904 PMID: 3063473 DOI: https://doi.org/10.1007/BF02554904
Hernández EH, Mosquera CG, De la Rosa V. Necrotizing fasciitis. Rev. Arch Méd Camagüey. 2015;19(6):654-664.
Laucks SS II. Fournier’s gangrene. Surg Clin North Am. 1994;74(6):1339-1352. https://doi.org/10.1016/S0039-6109(16)46485-6 PMID:7985069 DOI: https://doi.org/10.1016/S0039-6109(16)46485-6
Eke N. Fournier’s gangrene: a review of 1726 cases. Br J Surg. 2000;87(6):718-728. https://doi.org/10.1046/j.1365-2168.2000.01497.x PMID:10848848 DOI: https://doi.org/10.1046/j.1365-2168.2000.01497.x
Sorensen MD, Krieger JN, Rivara FP, et al. Fournier’s Gangrene: population based epidemiology and outcomes. J Urol. 2009;181(5):2120-2126. https://doi.org/10.1016/j.juro.2009.01.034 PMID:19286224 DOI: https://doi.org/10.1016/j.juro.2009.01.034
Sparenborg JD, Brems JA, Wood AM, Hwang JJ, Venkatesan K. Fournier’s gangrene: a modern analysis of predictors of outcomes. Transl Androl Urol. 2019;8(4):374-378. https://doi.org/10.21037/tau.2019.03.09 PMID:31555561 DOI: https://doi.org/10.21037/tau.2019.03.09
Safioleas M, Stamatakos M, Mouzopoulos G, Diab A, Kontzoglou K, Papachristodoulou A. Fournier’s gangrene: exists and it is still lethal. Int Urol Nephrol. 2006;38(3-4):653-657. https://doi.org/10.1007/s11255-005-2946-6 PMID:17160545 DOI: https://doi.org/10.1007/s11255-005-2946-6
Saijo S, Kuramoto Y, Yoshinari M, Tagami H. Extremely extended Fournier’s gangrene. Dermatologica. 1990;181(3):228-232. https://doi.org/10.1159/000247930 PMID:2269383 DOI: https://doi.org/10.1159/000247930
Xue M, Le NT, Jackson CJ. Targeting matrix metalloproteases to improve cutaneous wound healing. Expert Opin Ther Targets. 2006;10(1):143-155. https://doi.org/10.1517/14728222.10.1.143 PMID:16441234 DOI: https://doi.org/10.1517/14728222.10.1.143
Gutiérrez-Fernández A, Inada M, Balbín M, et al. Increased inflammation delays wound healing in mice deficient in collagenase-2 (MMP-8). FASEB J. 2007;21(10):2580-2591. https://doi.org/10.1096/fj.06-7860com PMID:17392479 DOI: https://doi.org/10.1096/fj.06-7860com
Riley KN, Herman IM. Collagenase promotes the cellular responses to injury and wound healing in vivo. J Burns Wounds. 2005;4(4):e8. PMID:16921413
De Castro García MP, Muñoz Montaño JR. Multicenter clinical study to evaluate the efficacy and safety of hyaluronic acid and enzyme cocktail in scars. Dermatología CMQ. 2020;18(2):84-92. https://www.medigraphic.com/pdfs/cosmetica/dcm-2020/dcm202c.pdf
Published
How to Cite
License
Copyright (c) 2024 Eugenia Paris, Jorge López-Berroa
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors contributing to AboutOpen agree to publish their articles under the Creative Commons NonCommercial 4.0 International License (CC BY-NC 4.0), which allows third parties to copy and redistribute the material providing appropriate credit and a link to the license but does not allow to use the material for commercial purposes and to use the material if it has been remixed, transformed or built upon.
Accepted 2024-01-09
Published 2024-02-26
