Fulminant gangrene of the penis was described by Fournier more than two hundred years ago, however, to this day there are a number of contraversies regarding its management. The diagnosis of Fournier's gangrene is essentially clinical, and although laboratory and various imaging techniques can be used, every acute and severe subcutaneous inflammatory process must be considered as the onset of Fournier's gangrene. Immediate treatment is essential and includes the use of combined broad spectrum antibiotics effective against both aerobic and anaerobic bacteria. Intensive supportive care is required for septicaemic patients. Immediate surgical debridement must be performed, this includes excision of necrotic tissue and drainage. Repeated surgery is usually required. To achieve better cosmetic results, special plastic surgery methods must be applied for reconstruction.
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