Treatment of Fournier's gangrene with a novel negative pressure wound therapy system

Fournier's gangrene (FG) is a complex condition that requires surgical debridement, hemodynamic support, antibiotics, and appropriate wound management. This study is the first to assess the use of a low-vacuum negative pressure wound therapy (LV-NPWT) system with low-adherent contact surface in two cases of FG. Methods. The protocol-of-care included twice weekly dressing changes and irrigation with a povidone-iodine-water mixture. Assessments included wound progression (% granulation tissue), ratings of dressing ingrowth, pain during treatment and at dressing changes, patient comfort, and ease-of-use. Results. A 51-year-old man (Patient A) developed FG after surgical removal of a perianal abscess. He received 16 days of LV-NPWT with five dressing changes. A 64-year-old man (Patient B) with multiple comorbidities, developed FG after traumatic injury. He received 20 days of LV-NPWT with six dressing changes. In both patients, LV-NPWT promoted rapid granulation tissue formation. Pain scores averaged low-to-moderate during treatment and dressing changes, and tissue ingrowth was minimal. Conclusion. Overall, ratings were favorable for LV-NPWT ease-of-use and patient comfort. Despite the complexity of these wounds, with the use of LV-NPWT, both wounds progressed to a point where they were able to successfully receive surgical closure with skin grafts and/or flaps. These cases may suggest that LV-NPWT may have a potential role in complex wound management