MULTIMODAL INTEGRATIVE APPROACH IN THE MANAGEMENT OF FOURNIER’S GANGRENE: A CASE STUDY ON EFFECTIVE RECOVERY

Abstract

Introduction: Fournier’s gangrene (FG) is a rapidly progressive and life-threatening form of necrotizing fasciitis affecting the perineal, genital, and perianal regions. It is characterized by extensive soft tissue necrosis, systemic toxicity, and a high mortality risk. Standard management involves prompt surgical debridement, broad-spectrum antimicrobial therapy, and intensive supportive care. However, despite advancements in medical and surgical interventions, FG remains associated with significant morbidity and mortality. Contributing factors include rising antimicrobial resistance and disruption of the host microbiome. A major determinant of prolonged morbidity is delayed wound healing, which often persists even after effective infection control.

Case presentation: This case report describes the clinical course of a 49-year-old male diagnosed with Fournier’s gangrene, presenting with a Fournier’s Gangrene Severity Index (FGSI) score of 7.

Discussion: The patient was managed through an integrative, multi-stage treatment approach. Initial intervention included Chhedana Karma (surgical debridement), systemic antibiotic therapy, and adjunctive local wound care using Panchavalkala Kashaya and Jatyadi Taila. In addition, oral administration of Ayurvedic formulations including Punarnava Mandura, Shigru Guggulu, Amalaki Rasayana, Ashwagandha Churna, and Giloya Ghana Vati was employed to promote systemic detoxification, immune modulation, and tissue regeneration. Upon development of healthy granulation tissue and favourable wound conditions, Seevana Karma (surgical wound closure via suturing) was performed.

Conclusion: This integrative treatment strategy resulted in progressive wound healing and complete recovery within six weeks.