Fournier's gangrene involving ail of the scrotum: treatment by multiple repeated surgical excisions, diversion colostomy, triple combination antibiotic therapy and postoperative intensive care.

Objectives : To describe and analyse the proposed therapeutic modalities to treat a series of patients suffering from Fournier's gangrene involving th e entire scrotum. Material and Methods : Four patients with macroscopically identical lesions of Fournier's gangrene involving the entire scrotum were managed by wide s urgical debridement, diversion colostomy, triple combination antibiotic the rapy, transfer to surgical intensive care, multiple repented operations und er general anaesthesia for excision of atonic tissues and mesh skin grafts. The colostomy was closed after 4 months. Results : All patients survived after skin cover. Three of them were review ed 2 months after restoration of gastrointestinal continuity and presented a good general status with a satisfactory esthetic result. The fourth patie nt was lost to follow-up. The mean reoperation rate was 6.5 per patient. Th e mean intensive care stay was 9.5 weeks. Conclusion : The choice of intensive treatment depends on the extent of the lesions. When the entire scrotum is involved, repented surgical excisions and systematic colostomy, combined with the other treatment modalities appe ar to be necessary to manage this disease, which stilt has a serious progno sis.