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Abstract
Introduction/Background Vulvar cancer represents only 4% of gynecological malignancies. Vacuum-assisted closure (VAC) is a non-pharmacologic/non-surgical means, which use negative pressure for spontaneous healing of the wound. It is reported that the use of VAC after vulvectomy helps cicatrization. We report one case of 82 years old woman, who was treated with VAC postoperatively for wound failure, after vulvectomy.
Methodology An 82-year-old woman was referred to our department for SCC of the vulva. There was no remarkable past medical and surgical history. She has noticed an ulcerating mass, approximately 2 cm, on the left labium majus, with no other symptoms. She was referred for a biopsy of the mass, which reviled SCC non-HPV related, p16 negative and grade 1. Computed Tomography (CT) of the lower, upper abdomen and of the chest were performed to stage the disease and they reported no findings. In our department, the patient underwent radical complete vulvectomy, followed by perineal reconstruction with V-Y flaps and bilateral inguinofemoral lymphadenectomy. She was referred on the ER 15 days postoperatively with wound failure on the vulvectomy site, with disruption of the skin and subcutaneous tissue, without systematic symptoms of infection.
Results Swap cultures for aerobic and anaerobic bacteria and for fungi were taken in order to confirm the wound infection, which revealed Staphylococcus aureus and candida albicans. The infection was treated with the proper antibiotics, according to the antibiogram. VAC treatment was placed to promote wound healing. After initial application, the dressing was changed within 48 hours and then 2 times weekly thereafter.
Conclusion The VAC device has been demonstrated to expedite the healing of complex wounds by enhancing tissue blood flow and oxygenation, reducing wound size and improving angioneogenesis. We present also photos of the improvement of the wound through the dressing changes, to establish the benefit of the VAC.
Disclosures All authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this case report.
