Objective: This retrospective investigation describes the infectious morbidity of patients following
radical vulvectomy with or without inguinal lymph node dissection.Methods: The charts of patients undergoing radical vulvectomy between January 1, 1986, and
September 1, 1989, were reviewed for age, weight, cancer type, tumor stage, operative procedure(s), prophylactic
antibiotic and its length of use, febrile morbidity, infection site, culture results, significant medical history, and length
of use and number of drains or catheters used.Results: The study group was composed of 61 patients, 14 of whom underwent a radical vulvectomy
and 47 who also had inguinal lymph node dissection performed. Twenty-nine patients (48%) had at least 1
postoperative infection. Five patients (8%) had 2 or more postoperative infections. The site and incidence of the
infections were as follows: urinary tract 23%, wound 23%, lymphocyst 3%, lymphatics (lymphangitis)
5%, and bowel (pseudomembranous colitis) 3%. The most common pathogens isolated from both urine and
wound sites were Pseudomonas aeruginosa, enterococcus, and Escherichia coli. A significant decrease in wound
infection was demonstrated when separate incisions were made for inguinal lymph node dissection (P <0.05).
The mean number of days to onset of postoperative infection for wound, urine, lymphatics, lymphocyst, and bowel were
11, 8, 57, 48, and 5, respectively.Conclusions: We conclude that the clinical appearance of post-radical vulvectomy infections is
delayed when compared with other post-surgical wound infections. Second, utilizing separate inguinal surgical
incisions may reduce infectious morbidity. Finally, tumor stage and type do not necessarily increase the infectious
morbidity of radical vulvar surgery.
Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country
