Secondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case-control study

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorDIAS-JR, Altamiro Ribeiro
dc.contributor.authorSOARES-JR, Jose Maria
dc.contributor.authorFARIA, Maria Beatriz Sartor de
dc.contributor.authorGENTA, Maria Luiza Noqueira Dias
dc.contributor.authorCARVALHO, Jesus Paula
dc.contributor.authorBARACAT, Edmund C.
dc.date.accessioned2019-11-06T18:49:04Z
dc.date.available2019-11-06T18:49:04Z
dc.date.issued2019
dc.description.abstractOBJECTIVES: Despite the number of surgical advances and innovations in techniques over time, radical vulvectomy frequently results in substantial loss of tissue that cannot be primarily closed without tension, the mobilization of surrounding tissues or even the rotation of myocutaneous flaps. The aim of this study was to evaluate the feasibility of leaving the surgical vulvar open wound for secondary healing in situations where primary closure of the vulvar wound is not possible. METHODS: This case-control pilot study analyzed 16 women with a diagnosis of squamous cell carcinoma of the vulva who first underwent inguinofemoral lymphadenectomy, 6-week sessions of chemotherapy and 25 daily sessions of radiotherapy. Afterward, excision of the vulvar lesion with free margins was performed between January 2011 and July 2017. Twelve patients underwent primary closure of the wound (control), and in 4 patients, the surgical wound was left open for secondary healing by means of a hydrofiber (case). The inclusion criteria were a) FIGO-2009 stage II up to IIIC; b) squamous cell carcinoma; and c) no evidence of pelvic or extrapelvic disease or pelvic nodal involvement. The exclusion criteria were extrapelvic disease or pelvic nodal involvement, another primary cancer, or a poor clinical condition. ClinicalTrials.gov: NCT02067052. RESULTS: The mean age of the patients at the time of the 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. The hospital stay duration was 2 days. Full vulvar healing occurred after an average of 30 days in the control group and after an average of 50 days in the case group. CONCLUSION: A secondary healing strategy may be an option for the treatment of vulvar cancer in situations of non-extensive surgical wounds when primary closure of the wound is not possible.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipICESP - Hospital das Clincias - Faculdade de Medicina de Sao Paulo (Sao Paulo - BR)
dc.identifier.citationCLINICS, v.74, article ID e1218, 5p, 2019
dc.identifier.doi10.6061/clinics/2019/e1218
dc.identifier.eissn1980-5322
dc.identifier.issn1807-5932
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/34059
dc.language.isoeng
dc.publisherHOSPITAL CLINICAS, UNIV SAO PAULOeng
dc.relation.ispartofClinics
dc.rightsopenAccesseng
dc.rights.holderCopyright HOSPITAL CLINICAS, UNIV SAO PAULOeng
dc.subjectInvasive Vulvar Cancereng
dc.subjectRadical Vulvectomyeng
dc.subjectSecondary Healingeng
dc.subject.othercomplicationseng
dc.subject.othercarcinomaeng
dc.subject.othermanagementeng
dc.subject.othersurgeryeng
dc.subject.wosMedicine, General & Internaleng
dc.titleSecondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case-control studyeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus5
hcfmusp.contributor.author-fmusphcALTAMIRO RIBEIRO DIAS JUNIOR
hcfmusp.contributor.author-fmusphcJOSE MARIA SOARES JUNIOR
hcfmusp.contributor.author-fmusphcMARIA BEATRIZ SARTOR DE FARIA
hcfmusp.contributor.author-fmusphcMARIA LUIZA NOGUEIRA DIAS GENTA
hcfmusp.contributor.author-fmusphcJESUS PAULA CARVALHO
hcfmusp.contributor.author-fmusphcEDMUND CHADA BARACAT
hcfmusp.description.articlenumbere1218
hcfmusp.description.volume74
hcfmusp.origemWOS
hcfmusp.origem.pubmed31482981
hcfmusp.origem.scieloSCIELO:S1807-59322019000100261
hcfmusp.origem.scopus2-s2.0-85071737845
hcfmusp.origem.wosWOS:000484257600001
hcfmusp.publisher.citySAO PAULOeng
hcfmusp.publisher.countryBRAZILeng
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hcfmusp.scopus.lastupdate2024-05-10
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