Factors complicating surgical management of the vulvar abscess

J Reprod Med. Mar-Apr 2010;55(3-4):139-42.

Abstract

Objective: To delineate risk factors and demographics in those patients with vulvar abscess that required surgical intervention, identify the most common bacterial isolate present at the time of surgery and comment on the progression to necrotizing fasciitis and the need for reoperation.

Study design: Retrospective chart review.

Results: A total of 47 vulvar abscesses with cellulitis were managed surgically. The most common isolate was methicillin-resistant Staphylococcus aureus (MRSA), which comprised 43% of the total. The median length of stay was 4 days (1-66), and 17% had stays >7 days. Diabetes was significantly related to hospitalization >7 days (38% vs. 6%, p<0.01), reoperation (25% vs. 3%, p=0.02) and progression to necrotizing fasciitis (19% vs. 0%, p=0.01).

Conclusion: When treating abscess of the vulva with cellulitis, antibiotic coverage of MRSA should be undertaken. Inpatient management with aggressive treatment for abscess of the vulva in those patients with concomitant diabetes is recommended.

MeSH terms

  • Abscess / microbiology
  • Abscess / surgery*
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Cellulitis / microbiology
  • Cellulitis / surgery
  • Diabetes Complications
  • Fasciitis, Necrotizing / epidemiology
  • Fasciitis, Necrotizing / surgery
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / therapy
  • Vulvar Diseases / microbiology
  • Vulvar Diseases / surgery*

Substances

  • Anti-Bacterial Agents