Abstract
INTRODUCTION: Fournier's gangrene is a rapidly progressive necrotizing fasciitis affecting the external genitalia and perineal region, with a poor prognosis and mortality rate of up to 20%. Prompt infection control, typically through extensive debridement, is essential for survival but may impair anal sphincter function and patient's QOL. In the present case, infection control and anal sphincter preservation were successfully achieved using the loop drainage as the initial treatment strategy. CASE PRESENTATION: A 77-year-old man with a history of alcoholic liver cirrhosis and cerebral infarction presented with fever, redness, and swelling around the anus. Fournier's gangrene was diagnosed based on physical examination and imaging findings, and emergency debridement was performed. A loop drainage technique using Penrose drains was used around the anus to preserve anal function. Postoperatively, additional debridement and drainage procedures resulted in successful infection control. No postoperative defecatory dysfunction was observed, and the patient was discharged with a preserved QOL. CONCLUSIONS: The loop drainage technique using Penrose drains may be an effective therapeutic option for perianal involvement in Fournier's gangrene.