{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T14:32:57Z","timestamp":1771338777049,"version":"3.50.1"},"reference-count":53,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Hintergrund Die Fournier-Gangr\u00e4n ist eine nekrotisierende Fasziitis Typ I der genitalen und perinealen Regionen, die insbesondere bei schweren Verl\u00e4ufen und systemischer Sepsis mit einer hohen Letalit\u00e4t vergesellschaftet ist. Der Schwerpunkt wurde auf die Evaluation der Risikofaktoren und Komorbidit\u00e4ten, auf das bakteriologische Spektrum, laborchemische Analysen, Mortalit\u00e4t und den Verlauf nach dem algorithmischen Vorgehen gelegt.<\/jats:p><jats:p>Material und Methoden Es wurden 10 Patienten am Bundeswehrzentralkrankenhaus Koblenz im Zeitraum von 2010 bis 2019 mit einer Fournier-Gangr\u00e4n und Sepsis sowie einer mindestens 48-st\u00fcndigen Intensivtherapie erfasst und deskriptiv analysiert.<\/jats:p><jats:p>Ergebnisse Die Patientenkohorte bestand aus 6 m\u00e4nnlichen und 4 weiblichen Patienten mit einem Durchschnittsalter von 62 Jahren (Range 42\u200a\u2013\u200a78 Jahre). Der durchschnittliche Zeitpunkt zwischen Auftreten der Beschwerden und der Krankenhausaufnahme betrug 4\u00a0Tage (Range 3\u200a\u2013\u200a5). Die h\u00e4ufigste Genese war ein Bagatelltrauma bei bestehender entgleister Diabeteserkrankung (30%). Diabetes mellitus (60%) und Adipositas (80% mit BMI\u2009&gt;\u200925) waren f\u00fchrende Risikofaktoren. Bei 90% der Patienten bestand eine polymikrobielle Besiedlung. Alle Patienten wiesen eine Multiorgandysfunktion auf und hatten einen SOFA-Score zwischen 3 und 17 Punkten. Die Mortalit\u00e4tsrate betrug in unserem Patientenkollektiv 40%. Signifikante Unterschiede zwischen \u00fcberlebenden und verstorbenen Patienten zeigten PCT, INR und aPTT (p\u2009&lt;\u20090,05).<\/jats:p><jats:p>Schlussfolgerung Die Fournier-Gangr\u00e4n ist insbesondere bei septischem Verlauf nach wie vor eine Erkrankung mit hoher Letalit\u00e4tsrate. Bei foudroyantem Verlauf bedarf es einer unmittelbaren Diagnosestellung sowie eines aggressiven operativen Vorgehens, um die Letalit\u00e4t so gering wie m\u00f6glich zu halten. Nach initialem radikalem D\u00e9bridement sowie stabilisierenden intensivmedizinischen Ma\u00dfnahmen folgen weitere operative Eingriffe. In der postakuten Phase hat sich die Anwendung der Vakuumtherapie zur Defektverkleinerung bew\u00e4hrt.<\/jats:p>","DOI":"10.1055\/a-1319-1734","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T04:27:30Z","timestamp":1612844850000},"page":"480-491","source":"Crossref","is-referenced-by-count":1,"title":["Diagnose und zielgerichtete Therapie der Fournier-Gangr\u00e4n mit septischem Verlauf: Vorstellung eines Behandlungsalgorithmus, Identifikation von Risikofaktoren, Betrachtung des Mikrobioms und Abgleich mit der Literatur"],"prefix":"10.1055","volume":"147","author":[{"given":"Aliona","family":"W\u00f6hler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Schwab","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"G\u00fcsgen","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Schaaf","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolin","family":"Weitzel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"J\u00e4nig","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr An\u00e4sthesie, Intensivmedizin und Notfallmedizin, Bundeswehrzentralkrankenhaus Koblenz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnulf","family":"Willms","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,2,8]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.cmi.2019.06.031","article-title":"Necrotizing skin and soft-tissue infections in the intensive care unit","volume":"26","author":"M Peetermans","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1159\/000445695","article-title":"Fournier\u02bcs Gangrene: Epidemiology and Outcomes in the General US Population","volume":"97","author":"M D Sorensen","year":"2016","journal-title":"Urol Int"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1046\/j.1365-2168.2000.01497.x","article-title":"Fournier\u02bcs gangrene: a review of 1726 cases","volume":"87","author":"N Eke","year":"2000","journal-title":"Br J Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1159\/000070137","article-title":"Predisposing factors and treatment outcome in Fournier\u02bcs gangrene. 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