Original Article 407 Corrêa Neto IJF, Sia ON, Rolim AS, Souza RFL, Watté HH, Robles L. Clinical outcomes of Fournier’s gangrene from a tertiary hospital. J Coloproctol, 2012;32(4): 407-410. ABSTRACT: Fournier’s gangrene is a progressive polymicrobial necrotizing fasciitis, caused by aerobic and anaerobic organisms. It causes an endarteritis obliterans leading to vessel thrombosis and subsequent cutaneous and subcutaneous necrosis of the perineal region. Objective: It was to describe the clinical outcomes of Fournier’s gangrene treated at the Hospital Santa Marcelina, São Paulo (SP), Brazil. Methods: This was a retrospective study conducted at the Hospital Santa Marcelina, in São Paulo (SP), Brazil, with patients with necrotizing fasciitis from September 2008 to March 2011. Results: We included 13 patients, most were males, and the mean age was 51.8 years old. Five of them presented with systemic infammatory response syndrome, only two had no comorbidities and 23% were obese. The most prevalent etiologic agent was E. coli, and the most common antibiotic regimen consisted of a combination of metronidazole with ciprofoxacin. The average number of surgical procedures performed by patient was 2.07, and 7 patients (53.8%) underwent colostomy formation. The mortality rate was 30.8%. Conclusions: Fournier’s gangrene is a severe disease, with high mortality rates. The physician should suspect its diagnosis early and have an aggressive treatment approach to achieve better outcomes. Keywords: Fournier gangrene; perineum; colostomy; bacterial infections; necrosis. ReSuMO: A gangrena de Fournier representa uma fasceíte necrotizante e progressiva de origem polimicrobiana, causada por organismos ae- róbios e anaeróbios. Tem como fsiopatologia a endarterite obliterante, que leva à trombose dos vasos cutâneos e subcutâneos e à consequente necrose da região perineal. Objetivo: Foi descrever os casos de gangrena de Fournier atendidos no Hospital Santa Marcelina, São Paulo (SP), Brasil. Métodos: Este estudo retrospectivo foi realizado no Hospital Santa Marcelina, em São Paulo (SP), com pacientes portadores de fasceíte necrotizante no período de setembro de 2008 a março de 2011. Resultados: Este estudo incluiu 13 pacientes, a maioria do sexo masculino, com média de idade de 51,8 anos. Cinco apresentavam síndrome da resposta infamatória sistêmica e somente dois não tinham comorbidades, sendo 23% deles obesos. O agente etiológico mais prevalente foi a E.coli, e o esquema de antibiótico mais utilizado foi a associação de me- tronidazol e ciprofoxacina. A média foi de 2,07 cirurgias por paciente, com realização de ostomia derivativa em 7 dos 13 pacientes (53,8%). A taxa de mortalidade foi de 30,8%. Conclusão: A gangrena de Fournier é uma doença grave, com alto índice de mortalidade. O médico assistente deve suspeitar precocemente essa afecção e realizar conduta terapêutica agressiva visando a melhores resultados. Palavras-chave: gangrena de Fournier; períneo; colostomia; infecções bacterianas; necrose. Clinical outcomes of Fournier’s gangrene from a tertiary hospital Isaac José Felippe Corrêa Neto 1 , Otávio Nunes Sia 2 , Alexander Sá Rolim 3 , Rogério Freitas Lino Souza 4 , Hugo Henriques Watté 5 , Laércio Robles 6 1 Assistant Physician at the Service of Coloproctology at the Hospital Santa Marcelina (HSM) – São Paulo (SP), Brazil; Associate member of the Sociedade Brasileira de Coloproctologia (SBCP) – São Paulo (SP), Brazil. 2 Former Resident Physician at the Service of Coloproctology, HSM – São Paulo (SP), Brazil; Affliate member of the SBCP – São Paulo (SP), Brazil. 3 Assistant Physician at the Service of Coloproctology at the HSM – São Paulo (SP), Brazil. 4 Assistant Physician at the Service of Coloproctology at the HSM – São Paulo (SP), Brazil. 5 Assistant Physician at the Service of Coloproctology at the HSM – São Paulo (SP), Brazil; Full member at the SBCP – São Paulo (SP), Brazil. 6 Physician, Head of the Department of Surgery and Coordinator of the Medical Residency Program in Coloproctology at the HSM – São Paulo (SP), Brazil. Study carried out at the Coloproctology Medical Residency Program of the Department of General Surgery at the Hospital Santa Marcelina – São Paulo (SP), Brazil. Financing source: none. Confict of interest: nothing to declare. Submitted on: 01/06/2012 Approved on: 13/09/2012