CP: 57 yo black male w/ hx of gout, hypertension and diabetes, on no medical treatment. Pt initially noted the development of a boil to his left (L) perineum on 9/14. He applied ointment to boil and stated it spontaneously began to drain on 9/17. He subsequently developed L scrotal swelling. Pt presented to Emergency Room on 9/19 w/ scrotal edema and mild tenderness and crepitus on palpation; pt was in acute renal failure - Creatinine 3.8 w/ an elevated white count - WBC 27.5. Pt was admitted for surgical debridement of Fournier's Gangrene, L scrotum.

DPMM: L scrotal exploration and L hemiscrotectomy; post-op saline moist gauze loosely wrapped around spermatic cord and testis and laid into wound bed, covered w/ ABD pad, IV antibiotics.

CCA: Totally detached spermatic cord and testis were laid directly into wound bed of L hemiscrotum, covered with adaptic and then black sponge of Negative Wound Pressure Therapy (NWPT) unit. Settings placed on continuous therapy 75 mmhg x's 7 days. NWPT stopped and wound covered with dry kerlix impregnated w /antimicrobial agent, polyhexamethylene biguinide (PHMB), changed BID. Arginaid oral supplements provided BID.

PO: Testis completly enveloped in scrotum and covered with beefy red granulation tissue within 7 days. Pt was discharged after 13 day hospital stay on dry to slightly moistened PHMB impregnated kerlix, until wound contracted and skin graft could be applied.

Conclusion: With the use of NPWT x's 1 week to reseat the testis into scrotal wound bed, followed by dry to slightly moist PHMB kerlix, this patient demonstrated accelerated wound granulation and contraction.