Reconstructive plastic surgery in the treatment of vulvar carcinomas

Eur J Obstet Gynecol Reprod Biol. 2008 Jan;136(1):102-9. doi: 10.1016/j.ejogrb.2006.08.026. Epub 2006 Nov 22.


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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gynecologic Surgical Procedures
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery
  • Plastic Surgery Procedures* / methods
  • Surgical Flaps
  • Survival Analysis
  • Treatment Outcome
  • Vulvar Neoplasms / mortality
  • Vulvar Neoplasms / surgery*
  • Wound Healing*