Period Prevalence and Risk Factors for Postoperative Short-Term Wound Complications in Vulvar Cancer

Abstract

Although clinicians recognize that postoperative wound management in patients with vulvar cancer (VC) is challenging, the prevalence and risk factors for different types of short-term wound complications (WCs) remain unclear. The aims of this study were: (1) to determine the period prevalence of postoperative short-term WCs and (2) to identify risk factors associated with short-term WCs in patients with VC. In a cross-sectional study in a Swiss University Hospital, a sample of 108 patients with VC treated surgically (and free of WCs at the time of admission) was included. Data were collected retrospectively from 2007 to 1997 from medical records using an investigator-developed data collection instrument to assess risk factors preoperatively and perioperatively and WCs that occurred within the first 30 postoperative hospital days. The period prevalence of WCs was calculated, and logistic regression was used to identify risk factors for WCs. The median age was 69 years (interquartile range [IQR], 21 years). The period prevalence of WCs was 45.4% (49/108), showing at least 1 of 8 assessed WCs per patient within the median hospital duration of 11 days (IQR, 12 days). The period prevalence for each type of WC was 31.5% for dehiscence, 12% for hematoma, 6.5% for necrosis, 5.6% for infections, 4.6% for seroma, 1.9% for lymph cysts, 1.9% for malignant wounds, and 0% for disturbed tissue formation. Two significant predictors of WCs were identified out of 14 risk factors examined (P < 0.05). The odds ratio (OR) for WC increased with the extent of surgical therapy, ie, from excision to hemivulvectomy and to radical vulvectomy, by a factor of 2.6 (OR, 2.6; 95% confidence interval [CI], 1.34-5.14), and, in the case of inguinofemoral lymphadenectomy, by a factor of 3 (OR, 3.0; 95% CI, 1.03-8.76). The high prevalence of short-term WCs (45.4%) indicates a need for systematic wound assessment and early risk management--especially after hemivulvectomy, radical vulvectomy, and inguinal lymphadenectomy.