How to treat a vaginal burn due to acetic acid?

Abstract

Up to the present, no recommendations have been made on vaginal and cervical burns. The aim of this article was to compare our treatment with other strategies found in the literature on the outcome of vaginal strictures and to propose a protocol for the treatment of vaginal burns. A patient underwent colposcopy with 100 % acetic acid, which caused deep vaginal burns. We treated her with daily vaginal packing with Vaseline gauze for 5 days and daily irrigation with saline solution for 2 weeks. Antibiotic capsules were used for 7 days. Subsequent physiotherapy was performed for 6 months. Topical hyaluronic acid was applied, and hyaluronic vaginal capsules were introduced from 1 month onwards and for 5 months. Healing took 1 month. No vaginal synechia or stricture was found at 6 months. In a review of literature, vaginal stents, topical estrogen, systemic antibiotics, and oral non-steroidal anti-inflammatory agents have been proposed. No cases of vaginal strictures or synechiae have been reported. The treatment has to be the simplest and the less traumatizing. Vaginal packing does not prevent vaginal strictures. Simple saline irrigation with a regular pelvic examination appears to be sufficient for the treatment of vaginal burns. Topical estrogens can be interesting if there is an atrophic mucosa. At distance, topical hyaluronic acid can be used to enhance healing.