Surgical approach to multifocal carcinoma in situ of the vulva

Thirty-nine patients with multifocal carcinoma in situ of the vulva were managed with en bloc removal of the involved skin and a split-thickness skin graft to the surgical defect. The characteristic presentations of this clinical entity are reported and options for the therapy are discussed. Thirty-nine percent of the patients developed a recurrence, but none of the recurrences was within the donated skin graft. No reports of dyspareunia or seriously altered sexual function were noted. The details of the surgical approach ae outlined and modifications of the original procedure are described.