Polypropylene Mesh Implantation in Combination With Vacuum-Assisted Closure in the Management of Metastatic or Locally Recurrent Vulvar Cancer

Riebe, E.; Öhlinger, R.; Thele, Franziska; Köhler, Günter

doi:10.1111/igc.0b013e3181c13343

Cited by 8 publications

(4 citation statements)

References 29 publications

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“…Treatment of invasive cancer of the vulva always includes an individual approach, which should be adapted to each patient. Maximally conservative surgical procedure should always be opted for in treatment which would result in healing and control of disease [19,20].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of invasive vulvar cancer

et al. 2012

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This paper presents the surgical treatment of invasive cancer of the vulva at the Department of Gynecology and Obstetrics inNovi Sad in the period from 2000 to 2010. Forty-one patients underwent different surgical procedures depending on their stage of the disease, age and general physical condition assessed according to the International Federation of Gynecologists and Obstetricians: wide excision to the healthy area with negative edges of 10 mm, simplex--radical vulvectomy or hemivulvectomy, block dissection of the vulva by Way, one-sided or bilateral lymphadenectomy and skin-muscle flap to cover the resulting skin defects. The number of removed lymph nodes on one side ranged from 8 to 19, the average being 12.6. Various postoperative complications (inflammation and wound dehiscence, lymphorrhoea, lymphocyst and limb lymphedema) developed in 9 (21.9%) and the local regional recurrence was recorded in 7 (17%) patients. The outcome was lethal in 4 (9.8%) surgically treated women. The primary surgical procedure is always individually planned and the choice of individual plans depends on three main factors: the size and position of the primary tumor in relation to the center line of the vulva (clitoral area--anus) and the involvement of regional lymph nodes. In order to reduce the psychosexual morbidity the preference is nowadays widely given to the local excision with adequate and histopathologically confirmed negative edges of the tumor together with determining the presence of metastases in sentinel lymph nodes.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of invasive vulvar cancer

et al. 2012

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“… Narducci et al [ 59 ] Retrospective 54 patients after RV or wide local vulvectomy with or without IFL and/or myocutaneous grafting; study group ( n = 30), control group ( n = 24) VAC or conventional care (perineal irrigation and air drying) Continuous negative pressure of 100–125 mmHg applied within 24 h of surgery; dressing replacement every 48–72 h 13. Riebe et al [ 60 ] Case series 2 patients P1: after palliative tumor debulking with IFL for locally advanced vulvar cancer P2: after RVIFL for locally advanced vulvar cancer Polypropylene mesh implantation + prophylactic VAC Continuous negative pressure of 125 mmHg applied directly after surgery; dressing replacement every 48–72 h 14. Shvartsman et al [ 61 ] Case report 41 year old patient after vulvectomy for recurrent Paget’s disease VAC + split-thickness skin graft Negative pressure of 50–125 mmHg applied directly after surgery and skin grafting; dressing replacement every 48 h 15.…”

Section: Methodsmentioning

confidence: 99%

“… Narducci et al [ 59 ] Median VAC therapy length 11 days (range 6–38 days); complete wound closure after 44 ± 18 days of therapy in study group vs. 60 ± 29 days in control group ( p = 0.0175); no significant difference in length of hospital stay Median follow-up 19.1 ± 11.2 months Partial necrosis of myocutaneous flap (1 patient); frequent vestibular stenosis NA 13. Riebe et al [ 60 ] P1: granulation tissue reached skin level on 32 postsurgical day P2: granulation tissue reached skin level on 39 postsurgical day 10 months None NA 14. Shvartsman et al [ 61 ] 16 days of therapy; successful graft adherence 12 months None NA 15.…”

Section: Methodsmentioning

confidence: 99%

“…Riebe et al presented case series study regarding two patients with locally advanced vulvar cancer who received extensive surgical treatment including tumor debulking and inguino-femoral lymphadenectomy [ 60 ]. After polypropylene mesh was implanted over the exposed blood vessels followed by VAC system application, authors observed faster wound healing with lack of complications.…”

Section: Negative Pressure Wound Therapy—an Alternative To the Standamentioning

confidence: 99%

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Growth factors, silver dressings and negative pressure wound therapy in the management of hard-to-heal postoperative wounds in obstetrics and gynecology: a review

Stanirowski

Wnuk

Cendrowski

et al. 2015

Arch Gynecol Obstet

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PurposeThe last two decades witnessed the development of numerous innovative regimens for the management of patients with abnormally healing and infected wounds. Growth factors, negative pressure wound therapy (NPWT) and antiseptic dressings containing silver are examples of methods with best documented efficacy, being widely used in the treatment of acute and chronic post-traumatic wounds, burns and ulcers of various etiology. As far as obstetrics and gynecology are concerned, prevention and treatment of infected, hard-to-heal postoperative wounds is of crucial importance. This article reviews the available literature to discuss the possibilities for use, efficacy and cost-effectiveness of growth factors, NPWT and silver dressings in the treatment of difficult-to-heal postsurgical wounds in obstetrics and gynecology.Materials and methodsAn extensive search of the English and Polish literature via PubMed and EMBASE databases was undertaken for articles published between January 1960 and April 30, 2014 to identify articles that described and assessed use, efficacy and cost-effectiveness of growth factors, silver dressings and NPWT in patients with hard-to-heal postoperative wounds following obstetric or gynecological surgery.ConclusionsLiterature review regarding the use of growth factors, NPWT and silver dressings suggests that these methods may play an important role in the management of wounds after invasive obstetric and gynecological procedures. Obese patients, patients after vulvectomy or prior radiation therapy may benefit most, however, due to non-numerous randomized reports, prospective studies on the use of above-mentioned methods in the treatment of postsurgical wounds following obstetric and gynecological interventions are required.

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Guidelines for vulvar and vaginal surgery: Enhanced Recovery After Surgery Society recommendations

Altman

Robert

Armbrust

et al. 2020

American Journal of Obstetrics and Gynecology

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This is the first collaborative Enhanced Recovery After Surgery Society guideline for optimal perioperative care for vulvar and vaginal surgeries. An Embase and PubMed database search of publications was performed. Studies on each topic within the Enhanced Recovery After Surgery vulvar and vaginal outline were selected, with emphasis on meta-analyses, randomized controlled trials, and prospective cohort studies. All studies were reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation system. All recommendations on the Enhanced Recovery After Surgery topics are based on the best available evidence. The level of evidence for each item is presented.

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Polypropylene Mesh Implantation in Combination With Vacuum-Assisted Closure in the Management of Metastatic or Locally Recurrent Vulvar Cancer

Abstract: Mesh implantation fulfills 2 purposes: (1) it protects exposed vessels and the wound can be vacuum sealed; and (2) it stabilizes the surgical bed, permitting the required radical excision locally and inside the vascular compartment.

Cited by 8 publications

References 29 publications

Surgical treatment of invasive vulvar cancer

Surgical treatment of invasive vulvar cancer

Growth factors, silver dressings and negative pressure wound therapy in the management of hard-to-heal postoperative wounds in obstetrics and gynecology: a review

Guidelines for vulvar and vaginal surgery: Enhanced Recovery After Surgery Society recommendations

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