Amniotic membranes in the treatment of necrotizing fasciitis complicating vulvar herpes virus infection

Article Abstract:

Necrotizing fasciitis (inflammation of connective tissue so severe that surrounding tissues begin to die) carries a high mortality of 20 to 40 percent. The principal problem is caring for the open wound that results after the diseased tissue has been surgically removed. The case report is presented of a 41-year-old woman with a herpes infection of her vulva (external female genitalia), who came to the hospital with a high fever and painful ulcers on the vulva and in the mouth. She was under treatment with chemotherapy for chronic myelogenous leukemia, a cancer of the blood cells. After the diagnosis of necrotizing fasciitis had been made and the diseased vulvar tissue had been removed, the wound was dressed with fresh amniotic membranes (the sac surrounding the fetus). These membranes had been obtained from deliveries of infants whose mothers who did not have syphilis or human immunodeficiency virus infection. The patient's wound responded well to this approach and the area healed well. However, the patient's high fever continued, and her stay in the hospital was complicated by conditions arising from her immunocompromized state. Two months later, she died, and was found to have widespread infection by cytomegalovirus. This is the first known report of necrotizing fasciitis as a consequence of a vulvar herpes virus infection. The advantages of amniotic membranes for temporary closure of surgical wounds after treating necrotizing fasciitis are discussed. Amniotic tissue has antibacterial properties. In addition, such dressings have many characteristics of an ideal surgical dressing; they are inexpensive, readily available, and reduce pain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Innovations, Infection, Causes of, Complications and side effects, Vulva, Surgical dressings, Amniotic sac, Amnion, Herpesvirus diseases, Herpesvirus infections, Necrotizing fasciitis

---

Radical vulvectomy with partial rectal resection and temporary colostomy as primary therapy for selected patients with vulvar carcinoma

Article Abstract:

Vulvar carcinoma (cancer) that involves the bladder, anus, and rectum is frequently treated with radical surgery. This surgery is disfiguring and requires a colostomy, an artificial opening in the colon, to replace the anus as the site of waste removal. Complications and deaths resulting from this operation are high, and the anatomical changes can have severe effects on the patient's psychological state. A less radical surgical technique that does not require the colostomy has been suggested as a way to lessen both the psychological and physiological damage of the surgery while still providing optimal treatment for the cancer. This study examined the use of the modified surgery in five patients. All cases were patients with vulvar carcinoma that involved the rectal area. The modified surgery was performed and a temporary colostomy was made. Results showed that after six months, four of the patients had their colostomies closed and normal bowel function returned. In long-term follow-up of between 18-96 months, all patients were alive and showed no signs of cancer. These results indicate this procedure is very effective in treating appropriate patients, allowing retention of normal bowel function and diminishing the psychological and physiological side effects of radical vulvar carcinoma surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Methods, Surgery, Cancer, Colostomy, Vulvar cancer, Vulvectomy

---

Ultrasonic surgical aspiration in the treatment of vulvar disease

Article Abstract:

Human papillomavirus infections in women can cause abnormal skin lesions to form on the outer layer of the vulva. Present treatments involve either removal of skin layers or destruction of the lesions with a carbon dioxide laser. The former also requires removal of normal skin, while the latter causes a number of problems such as burns and carcinogenic vapors, and thus a better treatment is desirable. Ultrasonic surgical aspiration was evaluated in the removal of vulvar lesions. It is a precise and rapid method for removing epidermal tissue and does not cause the problems that laser removal does. A rapidly vibrating tip is placed on the lesion allowing it to be easily aspirated into the tip. The technique was performed on 27 patients with vulvar lesions, 9 with vulvar intraepithelial neoplasia (VIN) and 18 with condylomata acuminata. Results showed 25 of the 27 patients experienced little pain or problems with the procedure, and no scarring occurred in any of the patients. After 50 weeks of follow-up, recurrence of disease was seen in 4 patients with condylomata and in 2 patients with VIN. These results indicate that ultrasonic surgical aspiration is highly useful in treating vulvar lesions. It causes little pain, no scarring, it heals quickly, and long-term results are excellent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Vulvar diseases, Epithelium, Ultrasonics in medicine, Medical ultrasonics

Similar abstracts:

• Abstracts: Surgical treatment of complications of acute myocardial infarction. Should survivors of myocardial infarction with low ejection fraction be routinely referred to arrhythmia specialists?
• Abstracts: The effect of neuroleptics on cognitive and psychomotor function. Orofacial dyskinesia in Down's syndrome
• Abstracts: Nifedipine in the treatment of severe preeclampsia. Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized double-blind placebo-controlled study

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.