The Role of Incisional Negative Pressure Wound Therapy in Vulvar Surgical Outcomes

To evaluate the effect of incisional negative pressure wound therapy (iNPWT) on surgical outcomes in patients undergoing wide vulvar surgical excision with simultaneous plastic reconstruction.

We conducted a single-centre retrospective cohort study at a São João Local Health Unit. The study included 21 patients diagnosed with vulvar malignancy who underwent wide vulvar surgical excision with immediate reconstruction with flaps between 2017 and 2024. Patients were divided into 2 groups based on postoperative wound management: the iNPWT group (N = 7), who received incisional negative pressure wound therapy, and the conventional care group (N = 14), submitted to standard wound management. The study's primary outcome was the occurrence of postoperative wound complications. Secondary outcomes assessed the occurrence of specific complications, such as wound infection, dehiscence, necrosis and hematoma, and length of hospital stay.

Overall wound complications occurred in 12 cases of conventional care patients (85.7%) but in none of the iNPWT group patients (P < 0.001). Compared to those submitted to incisional negative pressure wound therapy, the conventional care group had significantly higher prevalence of wound dehiscence (0.0% vs. 64.3%, P = 0.007) and infection (0.0% vs. 78.6%, P = 0.001). There was no significant difference (P = 0.521) in the necrosis rate. Median hospital stay was similar between groups (21.00 vs. 25.50 days, P = 0.488).

Fewer postoperative complications were observed in the iNPWT group compared to the conventional care group, particularly wound dehiscence and infection. These findings suggest that iNPWT may be a valuable tool in improving surgical outcomes and reducing postoperative morbidity in patients undergoing wide vulvar surgical excisions.