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Related Experiment Video

Updated: Jan 22, 2026

An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
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Evidence-based wound classification for vulvar surgery: Implications for risk adjustment.

I Mert1, W A Cliby1, K A Bews2

  • 1Division of Gynecologic Oncology, Mayo Clinic, Rochester, MN, USA.

Gynecologic Oncology
|June 29, 2019
PubMed
Summary

Vulvar procedures (VP) have higher surgical site infection (SSI) rates than abdominal hysterectomy. Simple vulvectomy should be Type II and radical vulvectomy Type III for accurate risk adjustment.

Keywords:
NSQIP databaseSurgical site infectionVulvar surgery

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Area of Science:

  • Gynecology
  • Surgical Oncology
  • Infectious Disease

Background:

  • The wound classification for vulvar procedures (VP) is unclear, leading to difficulties in assessing infection risk.
  • Surgical site infection (SSI) rates for VP are not well-documented, hindering accurate risk stratification.

Purpose of the Study:

  • To analyze SSI rates in women undergoing VP.
  • To establish appropriate wound classifications for VP to improve risk adjustment.

Main Methods:

  • Data from 2116 patients undergoing VP between 2008-2016 were analyzed from the National Surgical Quality Improvement Program (NSQIP) database.
  • SSI rates for VP were compared to those of total abdominal hysterectomy (TAH) cases, stratified by wound classification.
  • Descriptive analyses and trend tests were performed to evaluate correlations between wound type and SSI rates.

Main Results:

  • The overall SSI rate for VP (5.6%) was significantly higher than for TAH (3.8%).
  • While TAH showed increasing SSI rates with wound classification (Type I-IV), simple VP did not correlate with wound type (p=0.40).
  • Radical VP showed a non-significant trend of increasing SSI with wound type (p=0.08), with rates similar to Type IV TAH wounds.

Conclusions:

  • Patients undergoing VP face a high risk of SSI.
  • Simple vulvectomy should be classified as a Type II wound.
  • Radical vulvectomy should be classified as a Type III wound to enhance risk assessment accuracy.