Hyperbaric oxygen therapy or negative pressure therapy: what is the best form of treatment for patients with Fournier Syndrome? A systematic review of the literature

Authors

DOI:

https://doi.org/10.33448/rsd-v11i12.34558

Keywords:

Fournier Gangrene; Hyperbaric Oxygenation; Tissue Expansion Devices; Systematic review.

Abstract

Introduction: Fournier Syndrome can cause a series of serious organic dysfunctions, including death. Its perineal lesions are characterized by the presence of necrotic tissue and local or adjacent deformities. Hyperbaric oxygen therapy and negative pressure therapy are adjuvant techniques capable of minimizing the damage caused by the disease. Objective: To verify which technique is more effective in reducing the healing time of wounds from Fournier Syndrome. Method: Articles were collected from Pubmed, Web of Science, Cochrane Library, Scopus, and Embase databases using the search strategy: (“Fournier Gangrene'' AND “Negative-Pressure Wound Therapy” AND “Hyperbaric Oxygenation”). Inclusion criteria: studies that addressed male patients and the use of HBOT or VAC techniques in Fournier Syndrome. Exclusion criteria: unavailable studies in their entirety, which involved transsexual patients, who interrupted treatment with such techniques or who underwent other additional procedures to close the lesions. The revision was registered in PROSPERO under code “CRD42022314910”. Results and discussions: 14 articles were included in this study, discussing aspects inherent to healing time and hospital stay, risk factors, and patient's quality of life. The number of individuals undergoing HBOT exceeded those undergoing VAC, and a small group still used both techniques. Conclusion: Both techniques provide multiple benefits to the treatment of the disease. However, it is not possible to impossible to choose one more effective than the other due to limitations found in the study andn between their mechanisms of action. Conclusion: Both techniques provide multiple benefits to the treatment of the disease. However, it is not possible to choose one more effective than the other due to some limitations in the study, as well as the particularities of the patients and the techniques in question.

References

Azevedo, C. C. F. et al (2016). Síndrome de Fournier: um artigo de revisão. Connection online: revista eletrônica do UNIVAG, 15, 1-11. 10.18312/connectionline.v0i15.347

Benazir, E., Fabiani, P., Migliori, G., Chevallier, D., Peyrottes, A., Raucoules, M., Amiel, J., Mouiel, J. & Toubol, J. (1996). Gangrene of the perineum. Urology, 47(6), 935–939. https://doi.org/10.1016/S0090-4295(96)00058-1

Biranje, S. S. et al (2019). Hemostasis and anti-necrotic activity of wound-healing dressing containing chitosan nanoparticles. International journal of biological macromolecules, 121(2019), 936-946. http://dx.doi.org/10.1016/j.ijbiomac.2018.10.125.

Caldas, N. G. et al (2019). O uso da terapia a vácuo no tratamento da síndrome de Fournier - revisão da literatura, experiência do serviço e série de casos. Relatos de Casos Cirúrgicos, 5(3), 1-5. 10.30928/2527-2039e-20192229

Caldwell, M. D. et al (2020). Bacteria and Antibiotics in Wound Healing. Surgical Clinics Of North America, 100(4), 757-776. http://dx.doi.org/10.1016/j.suc.2020.05.007.

Cardoso, D. C. B. (2016). Uso da oxigenoterapia hiperbárica como terapia adjuvante no tratamento da Gangrena de Fournier: Revisão Sistemática. (Trabalho de Conclusão de Curso). Universidade Federal da Bahia, Salvador. https://repositorio.ufba.br/bitstream/ri/21366/1/Diandra%20Carvalhal%20Bonfim%20Cardoso.pdf

Cardoso, J. B & Féres, O. (2007). Gangrena de Fournier. Medicina (Ribeirão Preto), 40(4), 493-499. 10.11606/issn.2176-7262.v40i4p493-499

Correia, M. M. R. et al (2022). Gangrena de Fournier - do diagnóstico ao tratamento. Brazilian Journal Of Health Review, 5(3), 9368-9380. http://dx.doi.org/10.34119/bjhrv5n3-115

Filho, J. V. R. (2020). Manejo do paciente com gangrena de Fournier: um estudo de revisão. Trabalho de Conclusão de Curso. Pontifícia Universidade Católica de Goiás, Goiânia. https://repositorio.pucgoias.edu.br/jspui/bitstream/123456789/1048/1/TCC%20II%20finalizado_%20Jo%C3%A3o%20Filho%20.pdf.

Freitas, E. S. et al (2020). Síndrome de Fournier: ações do enfermeiro: uma revisão literária. Nursing, 3966-3981. http://www.revistanursing.com.br/revistas/264/pg98.pdf

Gamba, M. A., Petri, V. & Costa, M.T.F. (2016). Feridas - Prevenção, Causas e Tratamento. Grupo GEN. Recuperado de: https://integrada.minhabiblioteca.com.br/books/9788527729567

Guimarães, I. R. B. et al (2019). Síndrome de Fournier: relato de caso. Brazilian Journal Of Health Review, 2(6), 5364-5370. http://dx.doi.org/10.34119/bjhrv2n6-038.

Hirata, B. H. N. et al (2021). Abscesso prostático com Síndrome de Fournier: um relato de caso. Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo, 66 (1), 1-3. http://dx.doi.org/10.26432/1809-3019.2021.66.012.

Honório, H. M., & Santiago Júnior, J. F. (2021). Fundamentos das revisões sistemáticas em saúde. São Paulo, SP: Santos Publicações.

Janane, A., Hajji, F., Ismail, T. O., Chafiqui, J., Ghadouane, M., Ameur, A., Abbar, M. & Albouzidi, A. (2011). Terapia de oxígeno hiperbárico complementaria al desbridamiento en el control de la gangrena de Fournier: utilidad de la puntuación de un índice de severidad en la predicción de la gravedad de la enfermedad y la supervivencia del paciente. Actas urologicas espanolas, 35(6), 332–338. https://doi.org/10.1016/j.acuro.2011.01.019

Jones, E. G. & El-Zawahry, A. M. (2012). Curative treatment without surgical reconstruction after perineal debridement of Fournier's gangrene. Journal of wound, ostomy, and continence nursing: official publication of The Wound, Ostomy and Continence Nurses Society, 39(1), 98–102. https://doi.org/10.1097/WON.0b013e31823fe212

Lima, F.L.O. et al (2019). Síndrome de Fournier e sua potencial variabilidade microbiológica. Visão Acadêmica, 20(3), 39-46. file:///C:/Users/Cliente/Downloads/68007-276060-6-PB%20(3).pdf

Lucca, M., Unger, H. D. & Devenny, A. M. (1990). Treatment of Fournier's gangrene with adjunctive hyperbaric oxygen therapy. The American journal of emergency medicine, 8(5), 385–387. https://doi.org/10.1016/0735-6757(90)90231-n

Machado, R.A. et al (2021). Uso da oxigenoterapia hiperbárica no tratamento da síndrome de Fournier. Brazilian Journal Of Health Review, 4(2), 6752-675. http://dx.doi.org/10.34119/bjhrv4n2-225.

Mehl, A.A. et al (2010). Manejo da gangrena de Fournier: experiência de um hospital universitário de Curitiba. Revista do Colégio Brasileiro de Cirurgiões, 37(6), 435-441. http://dx.doi.org/10.1590/s0100-69912010000600010.

Michalczyk, Łukasz, Grabińska, A., Banaczyk, B., Braszko, M., Andrychowicz, A., & Ząbkowski, T. (2021). Efficiency of Hyperbaric Oxygen Therapy Combined with Negative-Pressure Wound Therapy in the Treatment Strategy of Fournier’s Gangrene –A Retrospective Study. Urology Journal, 18, 6797. https://doi.org/10.22037/uj.v18i.6797

Misiakos, E.P. et al (2016). Uncommon Locations of Gas Gangrene Treated Successfully With Surgical Debridement and the Vacuum-Assisted Closure Device; Int Surg, 101, 517-523. 10.9738/INTSURG-D-14-00296.1

Montrief, T. et al (2019). Fournier Gangrene: a review for emergency clinicians. The Journal Of Emergency Medicine, 57(4), 488-500. http://dx.doi.org/10.1016/j.jemermed.2019.06.023.

Murad, M. H., Sultan, S., Haffar, S. & Bazerbachi, F. (2018). Methodological quality and synthesis of case series and case reports. BMJ evidence-based medicine, 23(2), 60–63. https://doi.org/10.1136/bmjebm-2017-110853

Ozgok Kangal, M.K & Regan, J.P. (2022). Cicatrização de Feridas. [Atualizado em 8 de maio de 2022]. StatPearls [Internet], Ilha do Tesouro (FL): Publicação StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK535406

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A. & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.), 372 (71) https://doi.org/10.1136/bmj.n71

Pastore, A. L., Palleschi, G., Ripoli, A., Silvestri, L., Leto, A., Autieri, D., Maggioni, C., Moschese, D., Petrozza, V. & Carbone, A. (2013). A multistep approach to manage Fournier's gangrene in a patient with unknown type II diabetes: surgery, hyperbaric oxygen, and vacuum-assisted closure therapy: a case report. Journal of medical case reports, 7(1), 1-5. https://doi.org/10.1186/1752-1947-7-1

Punjataewakupt, A. et al (2018). The downside of antimicrobial agents for wound healing. European Journal Of Clinical Microbiology & Infectious Diseases, 38(1), 39-54. http://dx.doi.org/10.1007/s10096-018-3393-5.

Radaelli, F., Della Volpe, A., Colombi, M., Bregani, P. & Polli, E. E. (1987). Acute gangrene of the scrotum and penis in four hematologic patients. The usefulness of hyperbaric oxygen therapy in one case. Cancer, 60(7), 1462–1464. https://doi.org/10.1002/1097-0142(19871001)60:7<1462::aid-cncr2820600710>3.0.co;2-a

Ribeiro, D.C.S. (2017). A eficácia da terapia de curativo à vácuo. 6ºCONGREFIP, Realize,1-3. https://editorarealize.com.br/artigo/visualizar/27695

Ribeiro, J.P. et al (2018). A qualidade de vida dos pacientes após a cicatrização da síndrome de Fournier associada ao tratamento hiperbárico. Revista Científica Facmais, 15(4), 159-181. Recuperado de: https://revistacientifica.facmais.com.br/wp-content/uploads/2019/02/11.-A-QUALIDADE-DE-VIDA-DOS-PACIENTES-AP%C3%93S-A-CICATRIZA%C3%87%C3%83O-DA-S%C3%8DNDROME-DE-FOURNIER.pdf

Riegels-Nielsen, P., Hesselfeldt-Nielsen, J., Bang-Jensen, E. & Jacobsen, E. (1984). Fournier's gangrene: 5 patients treated with hyperbaric oxygen. The Journal of urology, 132(5), 918–920. https://doi.org/10.1016/s0022-5347(17)49946-0

Silberstein, J., Grabowski, J., & Parsons, J. K. (2008). Use of a Vacuum-Assisted Device for Fournier's Gangrene: A New Paradigm. Reviews in urology, 10(1), 76–80. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2312348/pdf/RIU010001_0076.pdf

Silva, M.P.B. et al (2020). Cuidados de enfermagem ao paciente com síndrome de Fournier: uma revisão de literatura. Política, Planejamento e Gestão em Saúde, 6,10-15. http://dx.doi.org/10.22533/at.ed.2622027084.

Souza, F.S.L. et al (2019). Assistência de enfermagem ao portador da síndrome de Fournier: uma pesquisa integrativa. Brazilian Journal Of Surgery And Clinical Research: BJSCR, 26(2), 54-62. https://www.mastereditora.com.br/periodico/20190407_140735.pdf

Syllaios, A., Davakis, S., Karydakis, L., Vailas, M., Garmpis, N., Mpaili, E., Kyros, E., Felekouras, E., & Papalampros, A. (2020). Treatment of Fournier's Gangrene With Vacuum-assisted Closure Therapy as Enhanced Recovery Treatment Modality. In vivo, 34(3), 1499–1502. https://doi.org/10.21873/invivo.11936

Tian, Y. et al (2018). Negative pressure wound therapy and split thickness skin graft aided in the healing of extensive perineum necrotizing fasciitis without faecal diversion: a case report. Bmc Surgery, 18(1), 1-4. http://dx.doi.org/10.1186/s12893-018-0411-6.

Wöhler, A. et al (2021). Diagnose und zielgerichtete Therapie der Fournier-Gangrän mit septischem Verlauf: vorstellung eines behandlungsalgorithmus, identifikation von risikofaktoren, betrachtung des mikrobioms und abgleich mit der literatur. Zentralblatt Für Chirurgie - Zeitschrift Für Allgemeine, Viszeral-, Thorax- Und Gefäßchirurgie, 1-12. http://dx.doi.org/10.1055/a-1319-1734

Yanaral, F., Balci, C., Ozgor, F., Simsek, A., Onuk, O., Aydin, M., & Nuhoglu, B. (2017). Comparison of conventional dressings and vacuum-assisted closure in the wound therapy of Fournier's gangrene. Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 89(3), 208–211. https://doi.org/10.4081/aiua.2017.3.208

Zagli, G., Cianchi, G., Degl'innocenti, S., Parodo, J., Bonetti, L., Prosperi, P., & Peris, A. (2011). Treatment of Fournier's Gangrene with Combination of Vacuum-Assisted Closure Therapy, Hyperbaric Oxygen Therapy, and Protective Colostomy. Case reports in anesthesiology,1-5. https://doi.org/10.1155/2011/430983

Ziser, A., Girsh, Z., Gozal, D., Melamed, Y., & Adler, M. (1985). Hyperbaric oxygen therapy for Fournier's gangrene. Critical care medicine, 13(9), 773–774. https://doi.org/10.1097/00003246-198509000-00020

Published

13/09/2022

How to Cite

CIRINO, G. A. dos R.; PAIVA, D. F. F.; AZEVEDO, A. H. de. Hyperbaric oxygen therapy or negative pressure therapy: what is the best form of treatment for patients with Fournier Syndrome? A systematic review of the literature. Research, Society and Development, [S. l.], v. 11, n. 12, p. e249111234558, 2022. DOI: 10.33448/rsd-v11i12.34558. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/34558. Acesso em: 28 dec. 2024.

Issue

Section

Health Sciences