Secondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case-control study

Despite the number of surgical advances and innovations in techniques over time, radical vulvectomy frequently results in substantial loss of tissue that cannot be primarily closed without tension, the mobilization of surrounding tissues or even the rotation of myocutaneous flaps. The aim of this st...

Full description

Saved in:

Bibliographic Details
Published in:	Clinics (São Paulo, Brazil) Vol. 74; p. e1218
Main Authors:	Dias-Jr, Altamiro Ribeiro, Soares-Jr, José Maria, de Faria, Maria Beatriz Sartor, Genta, Maria Luiza Noqueira Dias, Carvalho, Jesus Paula, Baracat, Edmund C
Format:	Journal Article
Language:	English
Published:	Brazil Elsevier España, S.L.U 2019 Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Faculdade de Medicina / USP Elsevier España
Subjects:	Adult Aged Carcinoma, Squamous Cell - surgery Female Humans Invasive Vulvar Cancer MEDICINE, GENERAL & INTERNAL Middle Aged Original Pilot Projects Radical Vulvectomy Reproducibility of Results Risk Factors Secondary Healing Surgical Wound - pathology Surgical Wound - therapy Treatment Outcome Vulvar Neoplasms - surgery Wound Closure Techniques Wound Healing Invasive Vulvar Cancer Secondary Healing Radical Vulvectomy
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Despite the number of surgical advances and innovations in techniques over time, radical vulvectomy frequently results in substantial loss of tissue that cannot be primarily closed without tension, the mobilization of surrounding tissues or even the rotation of myocutaneous flaps. The aim of this study was to evaluate the feasibility of leaving the surgical vulvar open wound for secondary healing in situations where primary closure of the vulvar wound is not possible. This case-control pilot study analyzed 16 women with a diagnosis of squamous cell carcinoma of the vulva who first underwent inguinofemoral lymphadenectomy, 6-week sessions of chemotherapy and 25 daily sessions of radiotherapy. Afterward, excision of the vulvar lesion with free margins was performed between January 2011 and July 2017. Twelve patients underwent primary closure of the wound (control), and in 4 patients, the surgical wound was left open for secondary healing by means of a hydrofiber (case). The inclusion criteria were a) FIGO-2009 stage II up to IIIC; b) squamous cell carcinoma; and c) no evidence of pelvic or extrapelvic disease or pelvic nodal involvement. The exclusion criteria were extrapelvic disease or pelvic nodal involvement, another primary cancer, or a poor clinical condition. ClinicalTrials.gov: NCT02067052. The mean age of the patients at the time of the intervention was 62.1. The distribution of the stages was as follows: II, n=6 (37 %); IIIA, n=1 (6%), IIIB, n=1 (6%) and IIIC, n=8 (51%). The mean operative time was 45 minutes. The hospital stay duration was 2 days. Full vulvar healing occurred after an average of 30 days in the control group and after an average of 50 days in the case group. A secondary healing strategy may be an option for the treatment of vulvar cancer in situations of non-extensive surgical wounds when primary closure of the wound is not possible.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	1807-5932 1980-5322 1980-5322
DOI:	10.6061/clinics/2019/e1218