A Retrospective Review of Fournier's Gangrene In CWM Hospital, Fiji, 2004-2011

Setting: The Colonial War Memorial Hospital (CWM) -largest referral hospital in Fiji
Objective: To document the epidemiology, presentation, etiology, management and outcomes of patients with Fournier's Gangrene admitted to CWM hospital from 2004-2011
Design: Descriptive retrospective review of all recorded Fournier's Gangrene patients in CWM hospital over 8 years
Results: There were 19 patients with Fournier's Gangrene, who all survived. A rising trend in the incidence of Fournier's Gangrene occurred from 2004 to 2010, with predominance among males in the I-Taukei (ethnic Fijian) population. Systemic Inflammatory Response Syndrome (SIRs) was the commonest presentation and scrotal abscess was the commonest etiology. The average length of stay was 17 days.
There was a high prevalence of Diabetes in the study but no statistically significant relationship was noted between Diabetes and a high Fournier's Gangrene Severity Index Score (FGSI), FGSI and length of hospital stay and Diabetes and the number of surgeries undertaken. There was statistically significant association found between the FGSI score and the number of surgical interventions (p =< 0.0001). Patients on average had 3.2 surgical interventions as part of management. The data although unavailable for all patients, showed that there was wide spread use to traditional medicine and that the infection is polymicrobial.
Conclusion:
Our results demonstrate that our surgical practices at CWM hospital appear to be effective in the management of severe cases of Fourniers Gangrene as classified by the FGSI.
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