Evaluation of the Role of VAC in the Treatment of Fournier's Gangrene

OBJECTIVE: Standard treatment for Fournier's gangrene (FG) includes hemodynamic stabilization, aggressive surgical debridement, and broad-spectrum antibiotics. However, prolonged hospitalizations and multiple debridements increase costs and reduce productivity. This study compares vacuum-assisted closure (VAC) therapy with open wound dressing (OWD) in post-debridement management of FG. MATERIALS AND METHODS: Data of 60 patients diagnosed with FG and treated in our clinic were retrospectively analyzed. Data collected included demographic characteristics, comorbid systemic diseases, presence of sepsis at initial presentation, the origin of the gangrene (urogenital or perianal), FGSI, the need for additional surgical interventions during debridement (such as orchiectomy, penectomy, or colostomy), the type of wound dressing used (open wound dressing [OWD] or vacuum-assisted closure [VAC]), the number of debridement sessions, length of hospital stay, the requirement for grafting during wound closure, and mortality outcomes. These variables were analyzed based on hospital records. RESULTS: VAC therapy was applied to 30 patients (50%). The mean age of patients in the VAC group was 63.1 ± 11.7 years, compared to 65.2 ± 12.1 years in the OWD group. The VAC group had a significantly shorter average hospital stay (15.17 ± 9.19 days) than the OWD group (22.8 ± 14.76 days) (p = 0.019). Additionally, the mean number of debridement sessions was significantly lower in the VAC group (3.27 ± 2.15) compared to the OWD group (4.87 ± 3.17) (p = 0.026). CONCLUSION: VAC therapy is an effective method for FG management, reducing debridement sessions and hospital stay compared to OWD.