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Abstract
Introduction Vulvar cancer is one of the rare malignancies in women, with surgical treatment showing the highest effectiveness. Extensive wound defects are difficult to close by stitching the edges of the wound. Tissue tension causes altered blood supply, which leads to suppuration of the wound, healing by secondary intention, and scarring. Delayed complications may be avoided using reconstructive plastic surgery. We aimed to show the advantages of reconstructive plastic surgery while treating vulvar cancer.
Methods We analyzed the outcomes of surgical treatment among 202 patients. Patients were grouped, depending on the method of closing the wound defect after radical vulvectomy: I - suturing the edges of the wound (n=110).; II – using fasciocutaneous flaps from the posterior thighs (n=42); III - stitching the vaginal wall and flaps with intradermal suture (n=50).
Results Suppuration and secondary healing were less common in Group II, compared with Group I (19.0% vs. 50.9%, respectively). In group III they were even further reduced down to 2.44%. A decrease in the frequency of delayed complications (dysuria, vaginal stenosis) and improved quality of life was also noted in Group III. The rate of local cancer recurrence did not exceed 10% in group II and III, while it equaled 24.6% in group I.
Conclusions Reconstructive plastic surgery after vulvectomy allows wide excision of perineal tissue while simultaneously improving the treatment results.
The wound defect is closed with fasciocutaneous flaps from the back of the thighs
Two years after radical vulvectomy and plastic surgery with fasciocutaneous flaps