{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:46:55Z","timestamp":1787168815122,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Fournier\u2019s 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.<\/jats:p>","DOI":"10.3390\/jpm12101695","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T22:18:13Z","timestamp":1665526693000},"page":"1695","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Negative Pressure Wound Therapy for the Treatment of Fournier\u2019s Gangrene: A Rare Case with Rectal Fistula and Systematic Review of the Literature"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3879-2678","authenticated-orcid":false,"given":"Michele","family":"Altomare","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy"},{"name":"General Surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Benuzzi","sequence":"additional","affiliation":[{"name":"General Surgery Residency Program, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1471-439X","authenticated-orcid":false,"given":"Mattia","family":"Molteni","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Vita-Salute, San Raffaele Scientific Institute (HSR), 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Virdis","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Spota","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5453-8901","authenticated-orcid":false,"given":"Stefano Piero Bernardo","family":"Cioffi","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4286-8866","authenticated-orcid":false,"given":"Elisa","family":"Reitano","sequence":"additional","affiliation":[{"name":"Ospedale Maggiore Della Carit\u00e0 di Novara, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Renzi","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2409-2109","authenticated-orcid":false,"given":"Osvaldo","family":"Chiara","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"},{"name":"Department of Medical-Surgical Physiopathology and Transplantation, University of Milan, Festa del Perdono 7, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Sesana","sequence":"additional","affiliation":[{"name":"Tissue Bank and Tissue Therapy, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7874-2640","authenticated-orcid":false,"given":"Stefania","family":"Cimbanassi","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"},{"name":"Department of Medical-Surgical Physiopathology and Transplantation, University of Milan, Festa del Perdono 7, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s13017-018-0219-9","article-title":"2018 WSES\/SIS-E consensus conference: Recommendations for the management of skin and soft-tissue infections","volume":"13","author":"Sartelli","year":"2018","journal-title":"World J. 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