BACKGROUND: There is compelling evidence that treating high-grade squamous intraepithelial lesions (HSIL), the anal squamous cell cancer (ASCC) precursor, reduces the risk of developing ASCC. Using high-resolution anosco...BACKGROUND: There is compelling evidence that treating high-grade squamous intraepithelial lesions (HSIL), the anal squamous cell cancer (ASCC) precursor, reduces the risk of developing ASCC. Using high-resolution anoscopy (HRA), surgical excision, ablative and topical therapies are widely used to treat HSIL. OBJECTIVES: With ASCC incidence increasing and new guidelines on screening high-risk patients, we sought to evaluate the efficacy and safety of HSIL treatment modalities. DATA SOURCES: EMBASE, MEDLINE, and Cochrane databases were searched for English-language, original studies specifically on HSIL or anal intraepithelial neoplasia (AIN) treatment from inception until December 31, 2025. REVIEW METHODS: Two reviewers independently reviewed abstracts and full-text articles with a third reviewer for discrepancies. Studies were evaluated for efficacy, recurrence and safety. RESULTS: Sixty-four original papers were evaluated, of which five were randomised controlled trials (two directly comparing different modalities). Numbers in each study and overall quality were low, and extensive heterogeneity existed in methodology. Side effects were common, but significant complications only occurred with surgical excision and photodynamic therapy. CONCLUSIONS: There is insufficient evidence to clearly identify any gold standard HSIL treatment modality. Regardless of the modality, treatment overall is safe, but recurrence is high. Studies directly comparing modalities with standardisation of methodologies and outcome measures are required, especially in light of increasing incidence of ASCC and up-take of HRA.
OBJECTIVE: Statistical Process Control methods have proven effective in enhancing outcomes monitoring and improvement within various clinical domains. This study investigates their application in supporting thoracic surg...OBJECTIVE: Statistical Process Control methods have proven effective in enhancing outcomes monitoring and improvement within various clinical domains. This study investigates their application in supporting thoracic surgical quality assurance processes across public hospitals in Queensland, Australia. METHODS: Retrospective evaluation of clinical data from thoracic surgeries performed at five public hospitals between January 1, 2019, and June 30, 2023, was conducted. Performance benchmarks were developed and assessed. Exponentially Weighted Moving Average charts and Funnel Plots were utilised for analysis and reporting. To account for common cause variation, Risk Adjustment models were developed and incorporated into the monitoring process. RESULTS: Outcome indicators of service quality throughout patient care were examined. Clinical outcome indicators identified as being suitable quality markers included: Death within 90 days, Major Acute Morbidity, Return to Theatre, Length of Stay, Readmission within 30 days and Tumour/Node/Metastasis (TNM) Up/Down Staging. SPC tools revealed patterns of variation over time and between sites, prompting investigation into contributing factors and opportunities for quality improvement projects. While the primary goal is to efficiently and effectively identify instances of underperformance, a structured approach to signal investigation can be used to initiate quality improvement projects when sustained performance is identified that is better than expected. CONCLUSIONS: SPC tools effectively facilitate clinical performance monitoring, aiding in timely detection and intervention in instances of altered performance. Careful interpretation of performance charts assists in identifying both declines and positive experiences, fostering continuous learning and improvement.
BACKGROUND: Endoscopic pilonidal sinus treatment (EPSiT) may reduce recovery burden, but comparative data against contemporary excisional practices in Australia are limited. METHODS: We conducted a retrospective cohort s...BACKGROUND: Endoscopic pilonidal sinus treatment (EPSiT) may reduce recovery burden, but comparative data against contemporary excisional practices in Australia are limited. METHODS: We conducted a retrospective cohort study of consecutive elective pilonidal operations in patients aged ≥ 12 at a tertiary Australian hospital (January 2018-May 2025). Analyses were performed at the operative episode level, including repeat procedures. EPSiT was compared with excisional surgery (off-midline flap closure, lay-open excision or primary closure). The primary outcomes were primary healing and recurrence after healing. Secondary outcomes were same-day discharge and opioid prescription at discharge. RESULTS: The cohort included 180 elective operative episodes in 144 patients: 115 EPSiT (63.9%) and 65 excisional (36.1%). Primary healing occurred in 158 episodes (87.8%) and did not differ between EPSiT and excision (89.6% vs. 84.6%; p = 0.330). Recurrence occurred in 26.6% and was similar between groups (29.1% vs. 21.8%; p = 0.322). EPSiT was associated with higher same-day discharge (86.1% vs. 21.5%; p < 0.001) and lower opioid prescribing at discharge (2.6% vs. 63.1%; p < 0.001). In the subgroup with prior emergency I&D (n = 66), primary healing remained similar (89.5% vs. 85.7%; p = 0.644), but recurrence after healing was higher following EPSiT (47.1% vs. 20.8%; p = 0.041). CONCLUSIONS: EPSiT achieved similar primary healing and recurrence to excisional surgery while enabling ambulatory care and opioid-sparing discharge. Prior abscess I&D was associated with higher recurrence after EPSiT despite comparable primary healing, supporting tailored counselling and selective EPSiT use when long-term durability is prioritised.
BACKGROUND: Intraoperative ileocecal masses may be encountered in patients operated on for acute appendicitis, often leading to unexpected surgical decisions. To facilitate preoperative identification of these patients,...BACKGROUND: Intraoperative ileocecal masses may be encountered in patients operated on for acute appendicitis, often leading to unexpected surgical decisions. To facilitate preoperative identification of these patients, we retrospectively analyzed patients operated on in our clinic. We investigated the potential value of ileocolic artery (ICA) and ileocolic vein (ICV) diameter measurements, which have been shown to aid in the diagnosis of acute appendicitis, for detecting pericecal masses mimicking acute appendicitis. METHODS: This retrospective study included 58 patients hospitalized with a prediagnosis of acute appendicitis. Patients were divided into two groups according to the surgical procedure performed: right hemicolectomy and appendectomy. Demographic data, duration of symptoms, physical examination findings, length of hospital stay, wound site infection, computed tomography (CT) and ultrasonography (US) findings, operative findings, laboratory parameters, and ICA and ICV diameter measurements on contrast-enhanced CT were evaluated. RESULTS: The appendectomy group included 30 patients, and the right hemicolectomy group included 28 patients. Significant differences were observed between the groups in terms of ICA and ICV diameters. In the right hemicolectomy group, ICA diameter was significantly smaller (p < 0.001), whereas ICV diameter was significantly larger (p = 0.004) compared with the appendectomy group. CONCLUSION: Measurement of ICA and ICV diameters on CT appears to be a promising tool for the preoperative detection of pericecal masses mimicking acute appendicitis. These vascular parameters may serve as complementary imaging markers to support surgical decision-making in patients presenting with suspected acute appendicitis.
BACKGROUND: Accurate pre-operative prediction of mortality after emergency laparotomy (EL) is essential as it may facilitate shared decision-making. The aim of our study was to compare the prognostic accuracy of three ri...BACKGROUND: Accurate pre-operative prediction of mortality after emergency laparotomy (EL) is essential as it may facilitate shared decision-making. The aim of our study was to compare the prognostic accuracy of three risk prediction tools following EL. METHODS: This retrospective cohort study included all consecutive adult patients (≥ 18 years) who underwent EL for any non-traumatic indication between December 2020 and October 2024 at Wellington Hospital (Aotearoa New Zealand). Demographic, physiological, comorbidity, and imaging data were extracted to enable risk calculation. Risk of 30-day mortality was determined using the National Emergency Laparotomy Audit prognostic model (P-NELA), American College of Surgeons National Surgical Quality Improvement Programme (ACS-NSQIP), and the New Zealand Surgical Risk (NZRISK) tool. Calibration was assessed using McFadden's pseudo-R (R ≥ 0.40, excellent; ≥ 0.30, good; ≥ 0.20, moderate; < 0.20, poor) and accuracy was evaluated with the c-statistic (< 1.0, excellent; < 0.90, good; < 0.80, fair; < 0.70, poor). RESULTS: A total of 312 EL procedures were performed, with observed 30-day mortality of 7.7%. P-NELA was most accurate in predicting 30-day mortality after EL (c = 0.91), followed closely by the ACS-NSQIP tool (c = 0.88; p = 0.43). NZRISK was the least accurate (c = 0.75) relative to both P-NELA (p = 0.0005) and ACS-NSQIP (p = 0.0008). Compared with ACS-NSQIP (R = 0.25) and NZRISK (R = 0.062), P-NELA was the only well-calibrated risk prediction tool (R = 0.38). CONCLUSIONS: P-NELA was most accurate in predicting 30-day mortality after EL, while NZRISK performed least reliably in our cohort. These findings highlight the importance of providing external validation for different risk prediction tools within diverse populations to improve peri-operative planning.
BACKGROUND: Oral antibiotics usually given for 24 h prior to surgery have been shown to result in lower anastomotic leak rates, as a result of luminal decontamination. Delivering antibiotics into the lumen of the intesti...BACKGROUND: Oral antibiotics usually given for 24 h prior to surgery have been shown to result in lower anastomotic leak rates, as a result of luminal decontamination. Delivering antibiotics into the lumen of the intestine at the time of surgery may be a simpler way to achieve this outcome. METHODS: An audit was undertaken of the first 50 consecutive patients undergoing luminal peri-anastomotic antibiotic washout performed by a single surgeon at two surgical institutions. The luminal washout initially involved metronidazole (500 mg) and gentamicin (240 mg) followed by the addition of ampicillin (1000 mg) for latter patients. The combined solution was delivered to the lumen of both sides of the colorectal anastomosis using either a soaked Raytec surgical gauze or syringe, or both. Follow up was performed for 30 days to assess for anastomotic leak, complications, clostridium difficile colitis and acute kidney injury, and at 90 days for mortality. RESULTS: The 30 and 90 day mortality was zero. There were no anastomotic leaks and no cases of clostridium difficile colitis. Complications occurred in six patients, with three readmissions within 30 days. There were no cases of acute kidney injury. CONCLUSION: Peri-anastomotic luminal washout with antibiotics is feasible and safe. It does not appear to have deleterious effects and should be compared to peri-operative oral antibiotics in larger clinical trials.
INTRODUCTION: Colorectal cancer is one of the most common cancers in Aotearoa New Zealand. Evidence supports that right colon cancer (RCC) and left colon cancer (LCC) represent distinct entities, with RCC associated with...INTRODUCTION: Colorectal cancer is one of the most common cancers in Aotearoa New Zealand. Evidence supports that right colon cancer (RCC) and left colon cancer (LCC) represent distinct entities, with RCC associated with a poorer prognosis, despite accounting for stage. Oncogenic mutations in MMR protein expression, BRAF V600E, and RAS genes have been shown to differ significantly between RCC and LCC, influencing tumour behaviour and prognosis. METHODS: Histopathologic features of RCC and LCC in patients treated between 2018 and 2023 in a centre in Aotearoa New Zealand were evaluated. RCC was defined as arising from caecum to distal transverse colon, and LCC from splenic flexure to rectosigmoid junction. The primary outcomes were the rates of deficient MMR protein expression (dMMR), BRAF V600E, and NRAS gene mutations. Secondary outcomes included tumour characteristics, lymph node status, and AJCC prognostic stage. RESULTS: A total of 376 patients were included, for a total of 390 tumours. RCC had a higher rate of dMMR tumours compared to LCC (50.4% vs. 13.75%; adjusted OR 6.36, 95% CI: 3.57-11.35). There were no significant differences in the rates of BRAF V600E or NRAS gene mutations between sides. RCC was more likely to be mucinous adenocarcinoma (23% RCC vs. 10% LCC; OR 2.99, 95% CI: 1.64-5.49), and to be high-grade (18.7% vs. 12.5%; OR 1.68, 95% CI: 1.03-2.92) compared to LCC. CONCLUSION: RCC was associated with a higher rate of dMMR and high-grade tumours, and a greater proportion of mucinous adenocarcinomas.
BACKGROUND: Pathological complete response (pCR) following neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) is a key prognostic marker with implications for response-adapted management. Altho...BACKGROUND: Pathological complete response (pCR) following neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) is a key prognostic marker with implications for response-adapted management. Although magnetic resonance imaging (MRI) is central to response assessment, differentiating residual tumour from treatment-related changes remains challenging. Artificial intelligence (AI) and machine learning (ML) models applied to MRI show promise in predicting pCR; however, variability in methodology and performance limits clinical translation. METHODS: A search of Embase, Medline, Cochrane and Web of Science was conducted in April 2025 in accordance with Preferred Reporting Items for Reviews and Meta-Analysis (PRISMA) guidelines. Eligible studies used MRI-only AI or ML models to predict pCR following chemoradiotherapy in adults with rectal cancer. Screening, full-text review and data extraction were performed independently by two reviewers. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). RESULTS: Twenty-two studies comprising 94 predictive models were included. Most studies were retrospective, used T2-weighted MRI and demonstrated variability in MRI protocols, modelling methods and validation strategies. Only five studies conducted external validation. Median AUC was 0.801, with performance ranging from poor to excellent (AUC 0.49-0.997). CONCLUSION: MRI-based AI models demonstrate moderate discriminative performance for predicting pCR following neoadjuvant therapy in LARC. However, methodological heterogeneity, inconsistent reporting and limited external validation currently hinder generalisability. Greater methodological standardisation and multicentre external validation are required before clinical implementation.
BACKGROUND: The choice of anastomotic technique in minimally invasive oesophagectomy (MIO) may influence postoperative morbidity and long-term outcomes. The primary aim of our study is to determine whether circular (CS)...BACKGROUND: The choice of anastomotic technique in minimally invasive oesophagectomy (MIO) may influence postoperative morbidity and long-term outcomes. The primary aim of our study is to determine whether circular (CS) or linear-stapled (LS) anastomosis is associated with anastomotic complications following MIO. METHODS: A retrospective cohort study was conducted of patients undergoing two-stage MIO with intrathoracic anastomosis for oesophageal cancer between January 2011 and December 2023. The primary outcome was anastomotic leak and stricture formation. Secondary outcomes included postoperative complications and overall survival. Multivariate logistic regression was used to identify independent risk factors for anastomotic leak and stricture. RESULTS: A total of 245 patients were included: 161 (65.7%) underwent CS and 84 (34.3%) LS anastomosis. The leak rate was higher in the circular group (13.0%) compared to the linear group (8.3%), though not statistically significant (p = 0.271). Leaks in the linear group were more likely to be Grade C (71.1% vs. 28.6%). The incidence of post-operative complications, long-term disease-free survival, and overall survival were comparable. Stricture rates were similar between techniques (17.4% circular vs. 16.6% linear; p = 0.817). On multivariate analysis, active or recent smoking (within 3 months) was independently associated with stricture formation. Ischaemic heart disease was independently associated with anastomotic leak. CONCLUSIONS: Anastomotic technique (circular or linear-stapled) was not associated with an increased risk of anastomotic leak or stricture in patients undergoing MIO with intrathoracic anastomosis. Modifiable patient factors, including recent smoking and ischaemic heart disease, were independent predictors for anastomotic complications.
BACKGROUND: Major trauma recovery extends beyond physical healing, with psychological outcomes and patient experiences influencing long-term well-being. This study explored trauma survivors' experiences of follow-up care...BACKGROUND: Major trauma recovery extends beyond physical healing, with psychological outcomes and patient experiences influencing long-term well-being. This study explored trauma survivors' experiences of follow-up care and Accident Compensation Corporation (ACC) in New Zealand, and how these relate to psychological distress and social support. METHODS: A retrospective cohort study was conducted at Christchurch Hospital using New Zealand Major Trauma Registry data (May 2016-March 2020, Injury Severity Score ≥ 12). In 2020, eligible patients were invited to complete a follow-up survey including DSM-5-aligned screeners for PTSD, anxiety, and depression, questions on follow-up care and ACC, and a validated social support scale. Associations were assessed with chi-square and Mann-Whitney U tests; free-text responses underwent thematic analysis. RESULTS: Of 415 eligible patients, 134 (32.3%) responded. Issues accessing follow-up care were reported by 20 patients (14.9%), and ACC-related challenges by 33 (24.6%). Thematic analysis identified insufficient follow-up, lack of mental health support, communication gaps, and premature return-to-work expectations. Psychological morbidity was strongly associated with reported difficulties: patients screening positive for PTSD, anxiety, or depression were 3-5 times more likely to report problems with follow-up or ACC (all p < 0.001). Lower perceived social support was also significantly associated with increased reported difficulties (p = 0.01-0.03). Injury severity and ICU admission were not associated. CONCLUSION: Mental health symptoms and poor social support were strongly linked to dissatisfaction with trauma follow-up and ACC processes. Routine psychological screening, improved communication, and coordinated support may enhance recovery outcomes in New Zealand's no-fault trauma system.
BACKGROUND: Full thickness defects of the oral cavity present a challenge to the surgeon for reconstruction. The advent of microsurgical vascular anastomosis has led to acceptance of free flaps as reconstructive procedur...BACKGROUND: Full thickness defects of the oral cavity present a challenge to the surgeon for reconstruction. The advent of microsurgical vascular anastomosis has led to acceptance of free flaps as reconstructive procedures of choice for such patients. But financial constraints and resource limited settings can force us to fall back on the ever-reliable Pectoralis major myo-cutaneous (PMMC) flap. The present study aspires to analyze the complications and functional outcomes of reconstruction with bi-folded PMMC flaps in female patients. MATERIALS AND METHODS: Retrospective analysis of the data of 60 female patients who were reconstructed with bi-folded PMMC flaps over a period of 2 years between July 2020 and June 2022 was done. Data was analyzed in terms of patient factors, flap-related complications, and functional outcomes. RESULTS: The overall complication rate including major/minor complications was 46.6% with flap detachment at 23.3% being the commonest complication observed. A total of 16.6% patients developed an Oro-cutaneous fistula and surgical site infection was seen in 11.66%. A total of 5% patients suffered a complete flap failure, whereas 11.66% suffered a partial flap failure. A total of 11.66% patients suffered from oral commissural incontinence and needed a redo commissuroplasty. Overall 33.33% patients were subjected to a second surgical intervention. Only 3.33% patients suffered from total inability to swallow liquids or solids. Only 6.66% patients had a completely unintelligible speech post operatively. CONCLUSION: The PMMC flap is a robust, dependable, and economical option for reconstruction of oral cavity defects with acceptable functional outcomes in settings where the microvascular surgical facilities are unavailable or are unaffordable.
BACKGROUNDS: To identify predictors of voiding impairment following transperineal prostate biopsy (TPPB) and evaluate the effect of alpha-blocker pretreatment: METHODS: A prospective observational study was conducted bet...BACKGROUNDS: To identify predictors of voiding impairment following transperineal prostate biopsy (TPPB) and evaluate the effect of alpha-blocker pretreatment: METHODS: A prospective observational study was conducted between June 2022 and May 2024, enrolling 279 patients undergoing TPPB. Patients were stratified into four groups according to the duration of alpha-blocker pretreatment. Baseline characteristics and voiding parameters were collected, including the international prostate symptom score (IPSS), quality of life, maximal flow rate (Q), and post-void residual urine. Follow-up assessments were performed at 7 and 30 days post-biopsy. The rate of voiding impairment and post-biopsy voiding parameters were compared across groups. Logistic regression analyses were conducted to identify independent predictors of post-biopsy voiding impairment. RESULTS: Baseline characteristics were comparable among all groups. At 7 days post-biopsy, patients with alpha-blocker pretreatment duration of < 12 months exhibited a lower voiding impairment rate, lower IPSS scores, and higher Q compared with patients without alpha-blocker pretreatment (p < 0.05). In contrast, patients with alpha-blocker pretreatment duration of > 12 months showed no differences in voiding impairment rate or voiding parameters compared to those without alpha-blocker pretreatment (p > 0.05). Logistic regression analyses demonstrated that diabetes mellitus (DM) was independently associated with post-biopsy voiding impairment, whereas alpha-blocker pretreatment for < 12 months exerted a protective effect (p < 0.01). CONCLUSION: TPPB is associated with voiding impairment. DM may serve as a predictor of post-biopsy voiding impairment, while alpha-blocker pretreatment for < 12 months may play a protective role.
BACKGROUND: Patients undergoing Hartmann's reversal (HR) frequently present with an incisional hernia. It is not clear whether HR and incisional hernia repair (IHR) should be performed simultaneously, given the high risk...BACKGROUND: Patients undergoing Hartmann's reversal (HR) frequently present with an incisional hernia. It is not clear whether HR and incisional hernia repair (IHR) should be performed simultaneously, given the high risk of complications. The aim of this study was to evaluate the outcomes of concomitant HR and IHR. METHODS: Patients who underwent HR between 2012 and 2024 were revised. The sample was divided into two groups: patients who underwent HR alone (HR) and those with concomitant HR and IHR (CP). The primary outcomes were 30-day overall morbidity, major morbidity (Clavien-Dindo III/IV complications), and anastomotic leak rates. Secondary outcomes were surgical site infections (SSI), surgical site occurrences (SSO), length of stay (LOS), reoperation rates, mortality, and hernia recurrence. RESULTS: A total of 52 patients were analyzed: 35 (67%) HR and 17 (33%) CP. Demographic variables were similar between groups. Operative time (HP: 196 vs. CP: 286 min, p = 0.001) was longer in the CP group. Most HR were laparoscopically performed (HR: 33 (94.2%) vs. CP: 2 (11.7%), p < 0.001). 30-day overall morbidity (HR: 15 (42.8%) vs. CP: 12 (70.5%), p = 0.06), major morbidity (HR: 2 (5.7%) vs. CP: 4 (23.5%), p = 0.06), and anastomotic leak (HR: 1 (2.8%) vs. CP: 0 (0%), p = 0.48) rates were similar between groups. No significant differences were observed regarding SSI (HR: 9 (25.7%) vs. CP: 3 (17.6%), p = 0.72) or reoperation rates (HR: 1 (2.8%) vs. CP: 0 (0%), p = 0.48). LOS was similar between groups (HR: 5 (2-16) days vs. CP: 6 (3-13) days, p = 0.2). No recurrences were observed in the CP group after a mean follow-up of 49 (12-132) months. One patient died in the HR group (HR: 1 (2.8%) vs. CP: 0 (0%), p = 0.48). CONCLUSION: Simultaneous HR and IHR might be feasible in very selected patients treated by experienced colorectal and abdominal wall surgeons. The small, heterogeneous, and imbalanced patient cohorts of our study, however, warrant further research to support the safety of the combined approach.
BACKGROUND: There is a lack of research about artificial intelligence's potential to explore neurosurgical literature. We aimed to investigate ChatGPT's and Gemini's ability to identify and outline studies about neurosur...BACKGROUND: There is a lack of research about artificial intelligence's potential to explore neurosurgical literature. We aimed to investigate ChatGPT's and Gemini's ability to identify and outline studies about neurosurgical training and trainees' anatomy understanding. METHODS: We asked ChatGPT 4.0 Turbo and Gemini 2.5 flash (in July 2025), and ChatGPT 5.3 and Gemini 3 flash (in March 2026) to list and summarize five papers: (1) about the use of virtual reality in neurosurgical training, (2) about the role of virtual reality in neurosurgery trainees' anatomy understanding, (3) that compared virtual reality with other neurosurgical training methods. We evaluated how many studies were successfully identified and accurately outlined. RESULTS: For ChatGPT 4.0 Turbo, the successful identification and summarization percentages were 100%/60%, 40%/40%, and 60%/40% respectively. For ChatGPT 5.3, the respective percentages were 100%/0%, 20%/0%, and 40%/0%. For Gemini 2.5 flash, they were 80%/60%, 40%/20%, and 0%/0%. For Gemini 3 flash, they were 60%/0%, 20%/0%, and 0%/0%. There was a tendency towards reporting outcomes in favor of virtual reality. Gemini 2.5 flash and 3 flash hallucinated 5/15 and 6/15 papers respectively. Gemini 2.5 flash misattributed first authorship in 8/15 papers. CONCLUSIONS: Apart from the excellent ChatGPT's ability to simply detect studies about the use of virtual reality in neurosurgical training, ChatGPT and Gemini did not provide reliable responses. Gemini performed worse and frequently hallucinated, while both platforms exhibited bias in favor of virtual reality. Newer versions performed generally worse than older ones. Ongoing development may improve these platforms' role in neurosurgical research.
OBJECTIVE: Standard treatment for Fournier's gangrene (FG) includes hemodynamic stabilization, aggressive surgical debridement, and broad-spectrum antibiotics. However, prolonged hospitalizations and multiple debridement...OBJECTIVE: Standard treatment for Fournier's gangrene (FG) includes hemodynamic stabilization, aggressive surgical debridement, and broad-spectrum antibiotics. However, prolonged hospitalizations and multiple debridements increase costs and reduce productivity. This study compares vacuum-assisted closure (VAC) therapy with open wound dressing (OWD) in post-debridement management of FG. MATERIALS AND METHODS: Data of 60 patients diagnosed with FG and treated in our clinic were retrospectively analyzed. Data collected included demographic characteristics, comorbid systemic diseases, presence of sepsis at initial presentation, the origin of the gangrene (urogenital or perianal), FGSI, the need for additional surgical interventions during debridement (such as orchiectomy, penectomy, or colostomy), the type of wound dressing used (open wound dressing [OWD] or vacuum-assisted closure [VAC]), the number of debridement sessions, length of hospital stay, the requirement for grafting during wound closure, and mortality outcomes. These variables were analyzed based on hospital records. RESULTS: VAC therapy was applied to 30 patients (50%). The mean age of patients in the VAC group was 63.1 ± 11.7 years, compared to 65.2 ± 12.1 years in the OWD group. The VAC group had a significantly shorter average hospital stay (15.17 ± 9.19 days) than the OWD group (22.8 ± 14.76 days) (p = 0.019). Additionally, the mean number of debridement sessions was significantly lower in the VAC group (3.27 ± 2.15) compared to the OWD group (4.87 ± 3.17) (p = 0.026). CONCLUSION: VAC therapy is an effective method for FG management, reducing debridement sessions and hospital stay compared to OWD.