Wound healing promotion following Fournier's gangrene

Medical Information

In the early 1990s, Gerald Haupt demonstrated that low-energy shock waves promote wound healing. Since then, numerous reports have been published regarding the positive effect of shock wave application on hard-to-heal wounds (e.g., diabetic ulcers). This led the primary author of this chapter to utilize extracorporeal shock wave therapy (ESWT) for wound healing following Fournier's gangrene, both with and without plastic coverage via rotational flaps.

Fournier's gangrene represents a necrotizing fasciitis in the area of the external genitalia and perineum. It requires immediate radical excision of the affected skin and subcutaneous areas, as well as intensive patient care. Following successful primary treatment, various techniques are used to cover skin defects (split-thickness skin grafts, rotational flaps), which carry a risk of secondary wound healing.

Based on positive experiences with low-intensity extracorporeal shock wave therapy (Li-ESWT) in the treatment of chronic skin ulcers, adjuvant treatment was recently reported in three cases involving secondary healing after rotational flap surgery. Subsequently, complete closure of the defect was achieved through localized tissue growth induced by shock waves.

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