FOURNIER'S GANGRENE: A CASE REPORT ON LIFE- SAVING DEBRIDEMENT TO SCROTAL RECONSTRUCTION

Fournier gangrene is necrotizing fasciitis of the genitalia and perineum that can extend to the abdominal wall, gluteus or lower extremities. Predisposing factors for Fournier gangrene include obesity, diabetes mellitus (DM), alcoholism, smoking, hypertension, chronic kidney disease, perianal trauma and immunosuppressive conditions: A 57-year-old male from Chennai presented to the General Surgery OPD with a one-week history of scrotal swelling, pruritus, and discomfort. His symptoms progressed to severe pain, fever, and foul-smelling discharge. He had no history of trauma but was newly diagnosed with uncontrolled type 2 diabetes mellitus (T2DM), systemic hypertension (SHTN), and ischemic heart disease (IHD) during admission. Emergency debridement was performed, followed by multiple wound dressings and eventual scrotal and penile reconstruction with a split-thickness skin graft. Fournier's gangrene requires prompt intervention to prevent systemic sepsis and mortality. In this case report , staged debridement followed by flap-based reconstruction and skin grafting achieved excellent outcomes. Challenges included metabolic control, surgical risk due to ischemic heart disease, and post-operative wound management. This case highlights the multidisciplinary approach and surgical techniques required for successful management and recovery in high-risk patients.