Abstract：
Fournier\'s gangrene (FG) is a Necrotizing Soft Tissue Infection (NSTI) of the perineal region characterized by high morbidity and mortality even if appropriately treated. The main treatment strategies are surgical debridement, broad-spectrum antibiotics, hyperbaric oxygen therapy, NPWT (Negative Pressure Wound Therapy), and plastic surgery reconstruction. We present the case of a 50-year-old woman with an NSTI of the abdomen, pelvis, and perineal region associated with a rectal fistula referred to our department. After surgical debridement and a diverting blow-out colostomy, an NPWT system composed of two sponges connected by a bridge through a rectal fistula was performed. Our target was to obtain healing in a lateral-to-medial direction instead of depth-to-surface to prevent the enlargement of the rectal fistula, promoting granulation tissue growth towards the rectum. This eso-endo-NPWT technique allowed for the primary suture of the perineal wounds bilaterally, simultaneously treating the rectal fistula and the perineum lesions. A systematic review of the literature underlines the spreading of NPWT and its effects.
摘要：
Fournier坏疽（FG）是会阴区域的坏死性软组织感染（NSTI），即使经过适当治疗，其特征也是高发病率和高死亡率。主要的治疗策略是手术清创,广谱抗生素,高压氧治疗,NPWT（负压伤口治疗），整形手术重建。我们介绍了一个50岁女性腹部NSTI的病例，骨盆,与直肠瘘相关的会阴区域转诊至我们部门。手术清创术和结肠造口术后，进行了NPWT系统，该系统由两根海绵通过直肠瘘通过桥连接。我们的目标是获得从外侧到内侧的愈合，而不是从深度到表面的愈合，以防止直肠瘘的扩大，促进肉芽组织向直肠生长。这种eso-endo-NPWT技术允许双侧会阴伤口的主要缝合，同时治疗直肠瘘和会阴病变。对文献的系统回顾强调了NPWT的传播及其影响。
