DOI: https://doi.org/10.36347/sasjs.2025.v11i08.001

Pages: 845-851

Fournier’s gangrene is a severe and potentially fatal genito-perineal infection that requires a mitigating radical surgical debridement, which leaves denuded genitalia requiring skin coverage. Restoring pre-gangrene genitalia that is cosmetically acceptable is challenging. Aim is to assess the adequacy of post gangrene residual genital skin in overcoming this challenge. Patients and Methods: A retrospective review of clinical records of all patients with FG managed by Urology department of a tertiary health institution between July 2005 and June 2025 was undertaken. Data retrieved and analysed included personal biodata, etiology, co-morbid factors, clinical presentation, extent of gangrene, treatment and outcome. Results: A total of 60 males were studied. Age range of 24-76 years (mean 47±15) was recorded. Complicated urethral trauma and stricture (16.7%), neglected strangulated inguinoscrotal hernia (11.7%), scrotal boils (8.3%); and Diabetes mellitus (16.7%), HIV infection (10%) were the main etiologic and predisposing factors. Clinically, patients presented with the triad of scrotal swelling, wound and pain in 98.3%, 81.7% and 73% of cases respectively. Staphylococcus aureus was the commonest bacterial isolate in 25% of cases. Mixed infections with proteus, E.coli, klebsiella was observed in 25% of patients. Extent of gangrene consisted of Scrotum only (76.7%), Scrotum and penis (18.3%), penis only, scrotum and perineum, scrotum and anterior abdominal wall in 1.67% patients each. >50% of scrotal surface was involved in 56.67% of cases. Post gangrene wound care included twice daily hypertonic saline sitz baths followed by honey-soaked gauze dressings. Wound coverage by secondary intention was achieved in 80%, and by secondary suturing in 16.67% of cases. Mortality occurred in 2 (3.3%) patients. Conclusion: The post gangrene residual genital skin has immense, innate elasticity and regenerative capacity, which should be utilized for restoring pre-gangrene genitalia.