Debridement Using the Hydrosurgery System and Negative Pressure Wound Therapy that Allowed Immediate Skin Grafting in a Patient withSevere Fournier's Gangrene

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  • Hydrosurgery Systemを用いたデブリードマンと局所陰圧閉鎖療法により早期の植皮術が可能であった重症フルニエ壊疽の1例

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<p>[Introduction] Debridement of Fournier's gangrene with an electrosurgical knife is characterized by a lack of swiftness and poor tissue selectivity. The hydrosurgery system (HS) is a new technique utilizing a high-pressure water jet for debridement, but on the other hand, negative pressure wound therapy (NPWT), a wound management technique that accelerates wound healing by maintaining negative pressure at the wound site, has hardly been used in the treatment of Fournier's gangrene for anatomical reasons.</p><p>[Case] A 56-year-old man with chief complaints of fever, perineal pain, and impaired consciousness was diagnosed with severe Fournier's gangrene through a physical examination. After debridement with HS, a sigmoid colostomy was performed on the 3rd postoperative day following cardiorespiratory stability. After NPWT for the treatment of a perineal wound, skin grafting was done on the 29th postoperative day. He was discharged in remission on the 48th postoperative day.</p><p>[Conclusion] It was possible to perform swift and tissue-selective debridement of Fournier's gangrene through HS. NPWT following HS was safe for wound bed preparation prior to skin grafting, and the patient had a good quality of life during NPWT.</p>

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