Use of negative pressure wound therapy after infection and flap dehiscence in radical vulvectomy: A case report

Llueca, Antoni; Herráiz, José Luis; Moral, Raquel del; Piquer, Dolors; Maazouzi, Yasmine; Segarra, Blanca; Barres, Jordan; Serra, Anna

doi:10.1016/j.ijscr.2017.11.002

Cited by 5 publications

(4 citation statements)

References 5 publications

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“…In our study, body mass index was 34.8±3.5 (32.2-39.0) kg/m 2 in patients with wound complications; determination of body mass index as 26.5±1.7 (24.1-30.1) kg/m 2 in patients without wound complications supports these findings. As is known, having received chemotherapy and/or radiotherapy before the operation slows down wound healing (11,18). However, in our patients, as expected, there was no significant difference between the patients who developed and did not develop complications, between the rates of radiotherapy and/or chemotherapy.…”

Section: Discussionsupporting

confidence: 68%

“…However, in our patients, as expected, there was no significant difference between the patients who developed and did not develop complications, between the rates of radiotherapy and/or chemotherapy. Similarly, although it was reported that lymph node dissection increased wound-related complications, in our study, there was no significant difference in the complication rate between patients who underwent and did not undergo lymph node dissection (18). In our opinion, the exposure of the moist labium minor or vaginal mucosa after resections involving labium majus E a r l y A c c e s s and the suturing of this area with the skin tissue is another factor that makes wound healing difficult.…”

Section: Discussioncontrasting

confidence: 56%

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Reconstruction of Vulva and Perineal Defects After Gynecological Oncological Surgery and Effectiveness of Local Flaps

Aksan

Karateke

Uzuneyüpoğlu

et al. 2021

Düzce Tıp Fakültesi Dergisi

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Aim: Although most defects can close by primary suturing after radical surgery of gynecological malignancies, different reconstruction options are available when large defects that require reconstruction occur. In this study, we present the treatment strategy and results for patients who underwent reconstruction after resection for gynecological cancer in the vulva and perineum. Material and Methods: A total of 18 patients who underwent reconstruction between May 2018 and July 2020 were included in this retrospective study. Demographics and clinical data, the resection operation, characteristics of the defect, and the reconstruction methods applied were evaluated. Postoperative treatment strategy and complication rates were evaluated. Results: The mean age was 62.3±13.2 (42-83) years. 88.9% of the patients had additional diseases. Pelvic exentration was performed in 5 (27.8%) patients, anterior resection in 2 (11.1%) patients and vulvectomy in 11 (61.1%) patients. The most common malignancy was squamous cell carcinoma, and mean defect size was 106±97 (12-476) cm 2 . Reconstruction was performed with a local fasciocutaneous flap in 16 (88.9%) patients, pedicled rectus myocutaneous flap in one (5.6%) patient, and skin graft in one (5.6%) patient. Wound complications occurred in 5 (27.8%) patients, partial flap necrosis in one (5.6%) patient, and recurrence in one (5.6%) patient in the long term. Conclusion: It is possible to reconstruction most of the vulva and perineal defects with local flaps after oncological resections, Considering the characteristics of the area and patient comorbidities, it should be kept in mind that prolonged wound problems may be seen, especially in vulvectomy patients.

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Section: Discussionsupporting

confidence: 68%

Section: Discussioncontrasting

confidence: 56%

Reconstruction of Vulva and Perineal Defects After Gynecological Oncological Surgery and Effectiveness of Local Flaps

Aksan

Karateke

Uzuneyüpoğlu

et al. 2021

Düzce Tıp Fakültesi Dergisi

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“…For vulvar chronic wounds, negative pressure therapy, application of platelet gel, and growth factors have been used with good healing results [ 2 , 9 ]. However, when lesions are small with cutaneous fistula, these options can be laborious with limited access.…”

Section: Discussionmentioning

confidence: 99%

Treatment of a Chronic Vulvar Wound by Hyperbaric Oxygen Therapy (HBOT)

Gauthier

Panchard

Huber

2022

Case Reports in Obstetrics and Gynecology

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We hereby report the case of a 66-year-old obese patient (BMI 30) with type 2 diabetes, who presented a chronic vulvar lesion on the left labia majora following surgical drainage of an abscess. After multiple unsuccessful treatments by antibiotics and local wound care, we proposed a trial of hyperbaric oxygen therapy (HBOT). The patient fully recovered after 54 sessions at 2.5 ATA, 95 minutes each. HBOT has been studied for perineal lesion such as skin atrophy or necrosis caused by irradiation but not for vulvar nonhealing chronic lesions in the case of impaired vascularization caused by diabetes. This case is, to our knowledge, one of the first publications about the healing boost of HBOT in chronic vulvar wounds due to vascular impairment.

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“…20 Vulvectomy not only has a significant psychological impact on patients but is also complicated by complex wound failures in 26% to 85% of cases, resulting in long hospital stays and cicatrisation. [22][23][24][25] Advanced age (mean age: 70 years) and obesity (BMI: 27-29) also influence this clinical picture. 22 Large defects of the scalp with exposed dura and skull also pose unusual challenges on reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Oncologic feasibility for negative pressure wound therapy application in surgical wounds: A meta‐analysis

Wang

Yao

Lin

et al. 2021

International Wound Journal

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Negative pressure wound therapy (NPWT) decreases postoperative complications of various surgeries. However, the use of NPWT for oncological surgical wounds remains controversial. To evaluate the association of NPWT with oncologic recurrence in surgical wounds without residual malignancy, we analysed studies that compared NPWT with conventional non-pressure dressings for cancer surgical wounds without residual tumour by August 12, 2020.We compared tumour recurrence rates and postoperative complications between the two procedures. The six studies included 118 patients who received NPWT, and 149 patients who received conventional non-pressure wound care. The overall quality of the included studies was high based on the Newcastle-Ottawa scale score of 7.5. Tumour recurrence after NPWT was not significantly different compared with conventional non-negative pressure wound care (9.3% versus 11.4%, P = 0.40). There was no significant heterogeneity between the studies (I 2 = 3%). Although NTWT was associated with a lower complication rate compared with the control group, the result was nonsignificant (P = 0.15). Application of NPWT in oncologic resection wounds without residual malignancy revealed no difference in local recurrence and may reduce the risk of postoperative complications compared with conventional non-negative pressure dressings. NPWT can be considered an alternative method for reconstruction in challenging cases.

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Use of negative pressure wound therapy after infection and flap dehiscence in radical vulvectomy: A case report

Abstract: HighlightsRadical vulvectomy is a very agressive surgery.Deshiscence of vulvar wound is one of the most feared complications.Negative wound pressure therapy could be incorporate in the management of this complications.

Cited by 5 publications

References 5 publications

Reconstruction of Vulva and Perineal Defects After Gynecological Oncological Surgery and Effectiveness of Local Flaps

Reconstruction of Vulva and Perineal Defects After Gynecological Oncological Surgery and Effectiveness of Local Flaps

Treatment of a Chronic Vulvar Wound by Hyperbaric Oxygen Therapy (HBOT)

Oncologic feasibility for negative pressure wound therapy application in surgical wounds: A meta‐analysis

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