A clinical study of Fournier’s gangrene and use of honey dressing in treatment

Subodh P. Ugane, Shrikant K. Kalbagwar, Sanjot B. Kurane


Abstract- background

Fournier’s gangrene is necrotizing fasciitis involving genitals and perineal regions.  Fournier’s gangrene is a surgical emergency. If not treated immediately it spreads rapidly causing septicemia leading to death. Mainstay of treatment is surgical and regular dressing. Various dressing materials are available like eusol,  in our study we use Honey as dressing material. This is a small work to attempt to study incidence, etiology and pathogenesis and use of dressing for the treatment of Fournier’s Gangrene.

Materials and methods in our study we study 40 male patients of Fournier’s gangrene. We studied clinico- pathology of disease and use of honey dressing for the management of Fournier’s gangrene. Out of 40 patients 18 were treated with honey as dressing material and remaining 22 with eusol.

Results- 40 patients were admitted and majority of patients were in age group > 60 years mean age was 54.08 _ 15.47 years. Majority of patients belonged to lower socioeconomic class 82.5%. Most of patients presented in hospital within 7 days of initial symptoms. In this study etiological causes found in 85% of patients and among which most common were urogenital causes 32.5%. Majority of patients had chronic alcoholism and bad hygiene as predisposing factors. 25% were associated with diabetes mellitus. In this study 12% of patients were HIV positive. Most common organism found in pus culture was E.coli (42.5%) followed by Coagulase negative Staphylococci in 32.5%, Klebsiella in 12.5%, Pseudomonas in 7.5% and no organism were isolated in 5%.Mean days required for healthy granulation by honey dressing was 9.62+- 4.5 days and for eusol was 10.5 +- 3.79 days. In our study mortality was 22.5%.


Fournier’s gangrene ; honey dressing

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Koukouras D, Kallidonis P, Panagopoulos C, Al-Aown A, Athanasopoulos A, Rigopoulos C, et al. Fournier's gangrene, a urologic and surgical emergency: presentation of a multi-institutional experience with 45 cases. Urol Int. 2011;86(2):167–172

Rodríguez Alonso A, Pérez García MD. Núñez López A, Ojea Calvo A, Alonso Rodrigo A, Rodríguez Iglesias B et al. Fournier's gangrene: anatomo-clinical features in adults and children. Therapy update. Actas Urol Esp. 2000;24(4):294–306

Molan PC. The evidence supporting the use of honey as a wound dressing. Int J Low Extrem Wounds. 2006;5(1):40-54.

Efem E. Recent advances in the Management of Fournier's Gangrene:

Preliminary observation Surgery Journal, February 1993 Vol 113, No.


Eke N. Fournier’s gangrene: a review of 1726 cases. Br J Surg 2000; 87:718-

Pravin Kumar, Mishra, S.M. Is Idiopathic Gangrene of Scrotum (Fournier's

Gangrene) Really Idiopathic? Indian Journal of Surgery. 1999 Vol. 61, No. 4,


Fournier JA, Jean-Alfred Fournier 1832-1914. Gangrene foudroyante de la

verge (overwhelming gangrene). Sem Med 1883. Dis Colon Rectum. 1988;


Morpurgo E, Galandiuk S. Fournier’s gangrene. Surg Clin N Am 2002;82:1213


Peter Ngugi, George Magoha, and Paul Nyaga. Fournier's ganrene in the HIV

era. Afr Health Sci. 2014 Dec; 14(4): 1063–1068.doi: 10.4314/ahs.v14i4.38.

PMCID: PMC4370088.

S. Ali Aji, S. Usman Alhassan and M. Muhammad Ujudud, "Fournier's Gangrene:

Experience with Management of 46 Cases in a Tertiary Institution," Open

Journal of Urology, Vol. 2 No. 3, 2012, pp. 109-112.

doi: 10.4236/oju.2012.23019.

Robson V, Dodd S, Thomas S. Standard antibacterial honey (Medihoney TM)

with standard therapy in wound care: randomized clinical trial. J Adv Nurs.

November 2009;565-575.

Olaitan PB, Adeleke OE, Ola LO. Honey: a reservoir for microorganisms and an

inhibitory agent for microbes. Afr Health Sci. September 2007;7(3):159-164.

Molan PC. The Antibacterial Activity of Honey. 1. The nature of the antibacterial

activity. Bee World. 1992; 73(1):5-28.

Lusby PE, Coombes A, Wilkinson JM. Honey: a potent agent for wound healing?

J Wound Ostomy Continence Nurs. 2002;29:295-300.

Sharp A. Beneficial effects of honey dressings in wound management. Nurs

Stand. October 2007;24(7):66-74.

Pieper B. Honey-Based Dressings and Wound Care. J Wound Ostomy

Continence Nurs. January/February 2009;36(1):60-66.

M. Subrahmanyam, S. P. Ugane. Honey dressing beneficial in treatment of fournier's gangrene. Indian Journal of Surgery. 2004;66(2):75-7.