The treatment of vulvar carcinoma is essentially surgical and involves a radical vulvectomy that may be associated with inguinal lymph node exploration. The surgery tries to be less mutilating but it is still a heavy surgery with a complication rate of 26 to 85%. Patients with this type of pathology have a poor quality of the integuments, a precarious vascularization, associated with the operative sacrifice of the subcutaneous tissue.
The proximity of the septic orifices means that infection and deep disunion are frequent. In order to avoid these complications we use negative pressure wound therapy (NPWT) as a preventive measure. The device is placed postoperatively immediately
to reduce secretions, areas of friction and thus accelerate healing to avoid and reduce the size of disunity.
We present the results of 3 patients presenting a vulvectomy in the context of a pre-cancerous lesion (VIN3) or a vulvar carcinoma treated by superficial partial or total radical vulvectomy with NPWT in immediate postoperative period for 10 days. NPWT allowed immediate healing or minimal superficial disunity in all 3 cases. The final healing was
achieved within a few weeks for all patients and avoided the heavy and painful local care.
In the absence of preventive NPWT, such dilapidated surgery is very often the cause of infection and disunity to the deep plane. Prophylactic NPWT is an essential tool for the management of vulvar lesions. This therapy allows a much faster healing by avoiding or reducing the size of the disunions that remain superficial.
Emilie Raimond
CHU de REIMS, Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, REIMS Cedex, France
Duminil Duminil
CHU de REIMS, Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, REIMS Cedex, France
Oliver Graesslin
CHU de REIMS, Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, REIMS Cedex, France
