Clinical spectrum and management of Fournier’s gangrene among diabetics and non-diabetics: A comparative study

Objectives: This study aimed to assess the clinical outcomes of Fournier’s gangrene and its predisposing factors in male diabetic and non-diabetic patients. We also evaluated the disease severity using the Fournier’s Gangrene Severity Index and examined management outcomes, including mode of wound closure and complications related to the disease and treatment. Methods: Patients with Fournier’s gangrene underwent admission, with detailed history collection. Disease severity was clinically and laboratory assessed. Empirical antibiotics preceded surgical management and microbial evaluation. Wound closure involved primary suturing, skin grafting, or flaps. Patients were called for regular follow-up after discharge, and complications were identified. Results: Our study has shown that the overall FGSI was much higher among diabetics as compared to non-diabetics, and the same goes for the mortality rate, which was much higher in diabetics, owing to the higher rate of complications among them. It was also found that the prognosis of Fournier’s gangrene is worse among diabetics. The mean number of debridement’s in the diabetic group (3.00 ± 1.016) was higher than the non-diabetic group (2.22 ± 1.003). The association between number of debridement’s in the two groups was statistically significant ( p = 0.001). Conclusion: Early diagnosis and aggressive management are crucial to reduce Fournier’s gangrene mortality. Effective diabetic control and repeated debridement are necessary to successfully manage these complex cases.