6533b856fe1ef96bd12b324b

RESEARCH PRODUCT

Reconstructive plastic surgery in the treatment of vulvar carcinomas

W. WeikelPaul-georg KnapsteinEric SteinerMarkus SchmidtHeinz Koelbl

subject

Adultmedicine.medical_specialtyThighSurgical FlapsDisease courseGynecologic Surgical ProceduresmedicineHumansSecondary healingAgedAged 80 and overRecurrent Vulvar CarcinomaWound HealingVulvar Neoplasmsbusiness.industryAdvanced stageObstetrics and GynecologyMiddle AgedPlastic Surgery Proceduresmedicine.diseaseSurvival AnalysisSurgeryPlastic surgeryStenosisTreatment Outcomemedicine.anatomical_structureReproductive MedicineFemaleVulvar CarcinomaNeoplasm Recurrence Localbusiness

description

Abstract Objective The results obtained using plastic surgery reconstruction in 207 patients with a primary or recurrent vulvar carcinoma were analyzed with regard to the surgical procedures applied, pre-treatment and post-operative findings, along with the long-term oncological disease course. Study design Standardized data concerning the surgical procedures applied and clinical factors were collected in a databank and statistically analyzed. Results The flaps employed were termed either ‘local' (cutaneous or fasciocutaneous; n =84) or ‘regional' (myocutaneous, n =123). For local flaps, the rate of secondary healing was 31%, dropping to 20% for regional flaps. Such healing disturbances often affected the donor region and did not lead to lasting clinical problems such as stenosis or distortion. Severe disturbances of wound healing (loss of more than 10%) were not observed in local flaps, whereas such problems were encountered in 5.9% of regional flaps. Gluteal thigh flaps were most frequently applied and were also the most successful type of myocutaneous reconstruction. Therapy was selected on an individual basis according to tumor status. Conclusion Plastic surgery reconstruction broadens the range of operative therapies available for the treatment of vulvar carcinomas, especially those at an advanced stage or recurrent tumors, and leads to a favorable oncological disease course as well as improved cosmetic results.

https://doi.org/10.1016/j.ejogrb.2006.08.026