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435 Secondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case- control study
  1. A Dias-1,
  2. E Gustavo Pires de Almeida2,
  3. C Anton1,
  4. JC Sadalla1,
  5. JP Mancusi1,
  6. D Igami1,
  7. A Silva e Silva1,
  8. D Sampaio Piato1,
  9. J Paula Carvalho1,
  10. JM Soares1 and
  11. E Chada Baracat1
  1. 1Instituto do Câncer do Estado de São Paulo, Gynecology Oncology, São Paulo, Brazil
  2. 2Instituto do Câncer do Estado de São Paulo, Pastic Surgery, São Paulo, Brazil


Objectives To evaluate the feasibility of leaving the surgical vulvar open for secondary healing in situations where primary closure of the vulvar wound is not possible.

Methods This is a case control pilot study analyzing 16 women with the diagnosis of squamous-cell carcinoma of the vulva that underwent first to inguinofemoral lymphadenectomy, them to 6 weeks sections of chemotherapy and 25 daily sessions of radiotherapy. After all, excision of the vulvar lesion with free margins was performed, between January 2011 to July of 2017. 12 patients underwent to the primary closure of the wound (control), and in 4 patients, the surgical defect was left open for secondary healing, by the use of hydrofiber (case). Inclusion criteria were a) FIGO-2009 stage II up to IIIC; b) squamous cell carcinoma; c) no evidence of pelvic or extrapelvic disease nor pelvic nodal involvement. Exclusion criteria was pelvic extra pelvic desease, pelvic nodal involment.

Results The mean age of the patients at the time of 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. Hospital stay was 2 days. Full vulvar healing in the control group occurred after an average of 30 days, and in the case group, 50 days.

Conclusions Secondary healing strategy may be an option for the treatment of vulvar cancer in situations of non-extensive surgical wound when primary closure of the wound is not possible.

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