018 A Case Report: Successful Wet Treatment of a Dissociated and Infected Surgical Wound After Radical Vulvectomy

A 72-year-old female, who had slight impaired glucose tolerance, was diagnosed the second stage of carcinoma of the vulva. On the second day after radical vulvectomy with inguinal lymphadenectomy, the center of the wound changed color into deep purple. On the 8th postoperative days, the swelling of the wound extended over the mons pubis and a thigh, so the infected wound, which reached the epimysium, was opened for the debridement. Pseudomonas aeruginosa and gram negative bacilli were detected from the wound. Firstly, the wound was cleaned by a physiological salt solution, streptokinase, and sulfadiazine silver. The gynecologist and nurses in charge discussed about the therapy under the consultation of a dermatologist and treated the wound by the wet treatment that a piece of gauze moisten by a physiological salt solution was exchanged 3 or 4 times a day after disinfecting by povidone iodine. On the13th postoperative days, the infection was controlled and on the19th days the skin was grafted from a thigh. After the successful skin grafting the patient was discharged. Carcinoma of the vulva tends to occur in elder women. Wounds are often dissociated because of an interruption in the circulation by the excessive extension of the skin. From the successful experience of wet treatment after a surgical wound infection, we recognized the necessity of close observation on surgical site and the importance of cooperation of the doctors and the nurses in charge.