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根治性外阴切除术后感染及皮瓣裂开后负压伤口治疗:一例报告

Use of negative pressure wound therapy after infection and flap dehiscence in radical vulvectomy: A case report.

作者信息

Llueca Antoni, Herraiz Jose Luis, Del Moral Raquel, Piquer Dolors, Maazouzi Yasmine, Segarra Blanca, Barres Jordan, Serra Anna

机构信息

Multidisciplinary Unit for Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellon, Spain, Dept. of Medicine, University Jaume I (UJI), Castellon de la Plana, Spain.

Multidisciplinary Unit for Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellon, Spain, Dept. of Medicine, University Jaume I (UJI), Castellon de la Plana, Spain.

出版信息

Int J Surg Case Rep. 2017;41:370-372. doi: 10.1016/j.ijscr.2017.11.002. Epub 2017 Nov 6.

Abstract

INTRODUCTION

Vulvar cancer has a lower incidence in high income countries, but is rising, in part, due to the high life expectancy in these societies. Radical vulvectomy is still the standard treatment in initial stages. Wound dehiscence contitututes one of the most common postoperative complications.

PRESENTATION OF CASE

A 76year old patient with a squamous cell carcinoma of the vulva, FIGO staged, IIIb is presented. Radical vulvectomy and bilateral inguinal lymph node dissection with lotus petal flaps reconstruction are performed as the first treatment. Wound infection and dehiscence of lotus petal flaps was seen postoperatively. Initial management consisted in antibiotics administration and removing necrotic tissue from surgical wound. After this initial treatment, negative wound pressure therapy was applied for 37days with good results.

DISCUSSION

Wound dehiscence in radical vulvectomy remains the most frequent complication in the treatment of vulvar cancer. The treatment of this complications is still challenging for most gynecologic oncologist surgeons.

CONCLUSION

The utilization of the negative wound pressure therapy could contribute to reduce hospitalization and the direct and indirect costs of these complications.

摘要

引言

外阴癌在高收入国家发病率较低,但部分由于这些社会的高预期寿命,其发病率正在上升。根治性外阴切除术仍是初始阶段的标准治疗方法。伤口裂开是最常见的术后并发症之一。

病例介绍

一名76岁患有外阴鳞状细胞癌的患者,国际妇产科联盟(FIGO)分期为IIIb期。首次治疗采用根治性外阴切除术及双侧腹股沟淋巴结清扫术,并进行莲花瓣皮瓣重建。术后出现伤口感染及莲花瓣皮瓣裂开。初始处理包括给予抗生素及清除手术伤口的坏死组织。经过这一初始治疗后,应用负压伤口治疗37天,效果良好。

讨论

根治性外阴切除术中的伤口裂开仍然是外阴癌治疗中最常见的并发症。对于大多数妇科肿瘤外科医生来说,这种并发症的治疗仍然具有挑战性。

结论

应用负压伤口治疗有助于减少住院时间以及这些并发症的直接和间接费用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80d6/5709344/d2fe0e1faf19/gr1.jpg

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