ObjectiveTo examine the role of bowel diversion and reconstructive surgeries in managing Fournier's gangrene (FG) to facilitate multidisciplinary collaboration between urologists, colorectal and plastic surgery teams.MethodsA review of the literature was conducted using the databases Medline, Embase, PubMed in June 2023. The review included studies that evaluated the outcomes of FG following reconstructive surgeries or diverting colostomies.ResultsThe existing evidence suggests that bowel diversion and colostomy formation could reduce the need for further debridement, shorten the time to wound healing, and facilitate skin graft or flap uptake in patients with FG. Additionally, the psychological impact of a stoma was shown not to be a major concern for patients. However, stoma carries a risk of perioperative complications and therefore may prolong the length of hospital stay. In reviewing the evidence for reconstruction in FG, large and deep defects seem to benefit from skin grafts or flaps. Noticeably, burial of testicles in thigh pockets has grown out of favour due to concerns regarding the thermoregulation of the testicles and the psychological impact on patients.ConclusionThe use of bowel diversion and reconstructive surgeries in managing FG is case dependent. Therefore, it is important to have close discussions with colorectal and plastic surgery teams when managing FG.

中文翻译：

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改道结肠造口术和重建术在治疗福尼尔坏疽中的作用——叙述性回顾

目的探讨肠改道和重建手术在治疗 Fournier 坏疽 (FG) 中的作用，以促进泌尿科医生、结直肠和整形外科团队之间的多学科合作。方法使用 Medline、Embase、PubMed 数据库于 2023 年 6 月对文献进行回顾。审查纳入了评估重建手术或结肠造口改道后 FG 结局的研究。结果现有证据表明，肠改道和结肠造口形成可以减少进一步清创的需要，缩短伤口愈合的时间，并促进患者皮肤移植或皮瓣的摄取与FG。此外，造口的心理影响并不是患者主要关心的问题。然而，造口存在围手术期并发症的风险，因此可能会延长住院时间。在回顾 FG 重建的证据时，大而深的缺损似乎受益于皮移植或皮瓣。值得注意的是，由于担心睾丸的温度调节和对患者的心理影响，将睾丸埋在大腿口袋中已经不再受欢迎。结论在治疗 FG 时使用肠改道和重建手术取决于具体情况。因此，在处理 FG 时，与结直肠和整形外科团队进行密切讨论非常重要。