title: Adjuvant use of platelet gel for wound breakdown prevention in advanced vulvar cancer surgery: a retrospective study.
abstract: OBJECTIVE
  The aggressive surgical strategy adopted for vulvar cancer is related to a high complication rate, usually consisting in infections and wound breakdown. Considering that platelet gel concentrate improves reparation of cutaneous lesions, the aim of the current retrospective study was to evaluate the efficacy of platelet gel application in women who had undergone radical surgery for vulvar cancer.
  
  
  METHODS
  We retrospectively analyzed record charts of 25 women referred to our academic departments with a diagnosis of vulvar cancer and who had undergone radical vulvectomy plus inguinofemoral lymphadenectomy between January 2007 and December 2011. During the reconstructive phase, a platelet gel was placed on the vaginal breach in 10 women (group A). In the remaining 15 patients, only surgical strategies were performed (group B). Primary outcomes were wound infection, necrosis, and/or breakdown of wounds rates; secondary outcomes were postoperative fever, hospital stay, and lastly, wound healing.
  
  
  RESULTS
  Compared to surgery alone, the platelet gel application was related to a significant decrease in wound infection (P = 0.032), necrosis of vaginal wounds (P = 0.096), and breakdown wound (P = 0.048) rates. In addition, in group A, reduction in postoperative fever rate (P < 0.001) and hospital stay (P < 0.001) were also detected. Compared to surgery alone, a faster wound healing in patients who had undergone surgery plus platelet (P < 0.001) were lastly observed.
  
  
  CONCLUSIONS
  In conclusion, platelet gel application before vulvar reconstruction represents an effective strategy to prevent wound breakdown after local advanced vulvar cancer surgery. However, further prospective data are needed to confirm these preliminary results.
authors.affiliation: *Department of Obstetrics and Gynaecology, "Magna Graecia" University; Gynaecologic Oncology Unit, "Tommaso Campanella" Cancer Center of Germaneto, Catanzaro, Italy; and †Department of Haematology Oncology, Immunohaematology and Trasfusion Medicine Unit, Pugliese-Ciaccio Hospital, Catanzaro, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Morelli
authors.forename: Morena Luigia
authors.initials: ML
authors.lastname: Rocca
authors.forename: Roberta
authors.initials: R
authors.lastname: Venturella
authors.forename: Annalisa
authors.initials: A
authors.lastname: Di Cello
authors.forename: Serena
authors.initials: S
authors.lastname: Del Negro
authors.forename: Marco
authors.initials: M
authors.lastname: Condorelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Dominijanni
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014846:Vulvar Neoplasms / Q000601:surgery*; D014945:Wound Healing / Q000187:drug effects