Fournier's Gangrene in Elderly Patients
Article Outline
Summary
The population of elderly individuals is growing at an accelerating rate in Taiwan, similar to other industrialized countries in the world. More elderly people are being treated in hospital. The clinical characteristics of Fournier's gangrene in the elderly (atypical symptoms) differ substantially compared with younger patients (typical symptoms), and the severity is strongly associated with increased age and age-related comorbidities. Underlying comorbid conditions have to be treated concurrently for overall effective management. Early recognition and prompt management are crucial for elderly patients succumbing to Fournier's gangrene. Surgical debridement has remained the cornerstone of treatment in current clinical practice.
Key Words: aging , necrotizing fasciitis
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PII: S1873-9598(08)70010-3
doi:10.1016/S1873-9598(08)70010-3
© 2008 Elsevier B.V. All rights reserved.
