%0 Journal Article
%T Negative Pressure Wound Therapy for the Treatment of Fournier's Gangrene: A Rare Case with Rectal Fistula and Systematic Review of the Literature.
%A Altomare M
%A Benuzzi L
%A Molteni M
%A Virdis F
%A Spota A
%A Cioffi SPB
%A Reitano E
%A Renzi F
%A Chiara O
%A Sesana G
%A Cimbanassi S
%J J Pers Med
%V 12
%N 10
%D Oct 2022 11
%M 36294834
%F 3.508
%R 10.3390/jpm12101695
%X 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.