Regarding the exams performed on admission, complete blood count

showed the presence of a hyperleukocytosis (> 10.000/mm3) in 39 patients (78%). The degree of anemia was severe necessitating blood transfusion in 9 patients (18%). Renal failure on admission (blood urea >0.5 g/l) was higher among the patients LY3009104 who died when compared to the survival group (p < 0.001). As for the location and extent of the injury, it was observed that FG was confined to the perineal area in 5 patients (10%), affecting the scrotum in 35 (70%) individuals. The gangrene extended to the abdominal wall in 9 patients (18%) and thorax in 1 patient (2%). It was found that the extension of the infection to the abdominal wall was a predictor of mortality (p < 0.003 ) (50% in the non survivors compared to 7% in the survivors). The most frequent bacterial organisms cultured from the wound sites were Escherichia coli (85.6%) and Klebsiella (40.5%). Before surgery, all patients underwent aggressive fluid resuscitation and were treated mostly with parenteral broad-spectrum triple antimicrobial agents, using a third-generation cephalosporin, an amino glycoside and metronidazole and received hemodynamic selleck inhibitor support when

required. Mechanical ventilation, continuous monitoring, and inotropic support were applied when necessary in patients with cardiopulmonary failure due to sepsis. All patients underwent radical surgical debridement, ranging from 1 to 10 procedures, with an average of 2.5. Debridement consisted of excision of all necrotic tissue, H 89 supplier cleansing with hydrogen peroxide, then saline and drainage. Along with the initial radical Ergoloid debridement, 5 patients (10%) underwent fecal diversion, with loop colostomy. Orchidectomy was carried out unilaterally for gangrenous testes in one patient (2%). It’s interesting to notice that mortality rate was 52.63% in the single-debridement group and 66.66% in repeated debridements; however, these rates were not significantly different (p = 0.08). Mechanical ventilation, due to sepsis was applied in 11 patients (22%). It was significantly higher in non survivor patients (91.6%) comparing to the survivors (0%) (p < 0.001). Patients had a median

hospital stay of 21 (range, 4–66) days. The median hospitalization time (MHT) for the surviving patients was 26.00 days compared to 8.00 days for the non-survivors (P < 0.001). As a result, evaluation of the outcome variables by univariate analysis demonstrated for statistically significant predictors of mortality, which were the advanced age, extension of the infection to the abdominal wall, renal failure and need of Mechanical ventilation (Table 3). However the presence of diabetes, female gender, interval between the symptoms and surgical intervention and repeated debridements did not appear as predictors of mortality. In the subsequent multivariate analysis, none of above studied variables was identified as independent predictors of mortality.