Debridement of Fournier's gangrene

The pictures illustrate a case of Fournier’s gangrene in a 58-year-old patient with diabetes and with benign prostatic hypertrophy. The patient presented with perineal pain and overt sepsis. The results of debridement of the scrotum and perineum is shown in the figure (A). Urinary and rectal diversion including a Foley catheter and rectal tube were used to keep the wound clean; a loop diverting colostomy had also been performed. A negative pressure wound therapy device (B) was applied with a seal obtained around the two tubes. Sheet skin grafting was subsequently performed to cover the penile shaft and the remaining open areas in the suprapubic and perianal regions.