Wednesday, February 25, 2009

Two Words

Fournier's Gangrene!

I remember hearing about a case of this on the unit, but I didn't get to see it. Well, last night I got well acquainted with it. I think it is, to date, the most fascinating, gruesome, eye popping, awesome disease process I have seen. I got lucky, really! I just happened to walk to another unit to see if I could be of any assistance. One nurse, Chad, was preparing to give a bath, but needed to do a dressing change first. When I saw the site of the dressing change, I knew I had struck gold! What lay behind the mass of ABD pads and saline-soaked gauze was a bout of gangrene that left the poor patients left testicle totally exposed.

The doctors had debrided the wound yesterday, and removed so much necrotizing flesh that today I was able to observe the left spermatic cords' descent through the internal oblique! I was so shocked to see real live anatomy that I began to call everything out by name as I saw it. It was a remarkable specimen to see, but unfortunately this poor patient is not doing well, and will probably have to go back in for more debridement.

That pretty much sums up my night! We did loose a patient sometime after I got off work last night, and we are sure to lose a few more when their families come to grips with their loved ones' demise. It's a sad, sad thing...death. C'est la vie.

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