Fournier's gangrene: Experience of the Department of Plastic and Reconstructive Surgery at Moulay Ismail Military Hospital, Meknes—A Report of Three Cases

Introduction: Fournier's gangrene is a rapidly progressive polymicrobial necrotizing fasciitis of the perineal, genital, and perianal regions. Despite advances in resuscitation and antibiotic therapy, this condition remains a medical and surgical emergency associated with substantial morbidity and mortality. Management relies on early resuscitation, appropriate antibiotic therapy, and aggressive, repeated surgical debridement, followed by reconstruction of the resulting tissue defects once the infection has been controlled.
Case Reports: We report a series of three patients managed in the Department of Plastic and Reconstructive Surgery at Moulay Ismaïl Military Hospital, Meknes, for Fournier's gangrene. All patients received multidisciplinary management combining resuscitation, broad-spectrum antibiotic therapy, repeated surgical debridement, and local wound care. Reconstruction was performed once a healthy tissue bed had been obtained, using techniques tailored to the extent of the tissue defect. In one patient, extension of the necrosis to the urethra required urethral reconstruction using a tubularized split-thickness skin graft over a silicone urethral catheter, protected by local advancement flaps. Anatomical and functional outcomes were satisfactory in all three patients.
Conclusion: Fournier's gangrene constitutes a therapeutic emergency whose prognosis depends essentially on the timeliness of diagnosis and the speed of management. The plastic surgeon plays a major role in the reconstruction of genitoperineal tissue defects, restoring cutaneous coverage, protecting vital structures, and improving functional and aesthetic outcomes.