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Practice Patterns in Fournier’s Gangrene in Europe and Implications for a Prospective Registry Study

ORCID
0000-0002-3409-8654
Affiliation
Department of Urology, University Medical Center Rostock, 18057 Rostock, Germany
Schneidewind, Laila;
Affiliation
Department of Urology, University Hospital of Bern, 3010 Bern, Switzerland
Kiss, Bernhard;
Affiliation
Department of Urology, University Hospital of Bern, 3010 Bern, Switzerland
Stangl, Fabian P.;
Affiliation
Department of Urology, University College London Hospitals, London NW1 2BU, UK
Tandogdu, Zafer;
ORCID
0000-0002-2909-0797
Affiliation
Clinic for Urology, Pediatric Urology and Andrology, Justus-Liebig-University Giessen, 35390 Giessen, Germany
Wagenlehner, Florian M. E.;
ORCID
0000-0003-3490-6460
Affiliation
Department of Urology, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
Johansen, Truls E. Bjerklund;
ORCID
0000-0001-6886-0750
Affiliation
Department of Urology, University of Szeged, 6720 Szeged, Hungary
Köves, Béla;
ORCID
0000-0003-3626-8669
Affiliation
Department of Urology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
Medina-Polo, Jose;
Affiliation
Department of Urology, Hospital Universitario Río Hortega, 47012 Valladolid, Spain
Tapia, Ana Maria;
Affiliation
Department of Urology and Pediatric Urology, University Medical Center RWTH Aachen, 52074 Aachen, Germany
Kranz, Jennifer

Background: Fournier’s gangrene (FG) is a life-threatening, necrotizing infection. Due to the rareness of the disease, it is challenging to plan robust prospective studies. This study aims to describe current practice patterns of FG in Europe and identify implications for planning a prospective FG registry. Methods: Online non-validated 17-items survey among urologists treating FG in in European hospitals. Questionnaires were analyzed with LimeSurvey (LimeSurvey GmbH Hamburg, Germany). Results: 229 responses from ten different European countries were submitted, and 117 (51.1%) urologists completed the questionnaire. The departments treat a mean of 4.2 (SD 3.11) patients per year. The urology department mostly takes the lead in treating FG patients ( n = 113; 96.6%). The practice in FG is very heterogenic and mostly case-based all over Europe, e.g., vacuum-assisted wound closure (VAC) is mostly used ( n = 50; 42.7%) as adjunct wound. The biggest challenges in FG are the short time to diagnosis and treatment, standardization and establishment of guidelines, and disease awareness. Additionally, participants stated that an international registry is an outstanding initiative, and predictive models are needed. Conclusions: There is no standard of care in the diagnosis, treatment, and long-term care of FG all over Europe. Further research could be conducted with a prospective registry.

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