WOUND-HEALING AFTER RADICAL VULVECTOMY AND INGUINO-FEMORAL LYMPHADENECTOMY - EXPERIENCE WITH GRANULOCYTE-COLONY-STIMULATING FACTOR (FILGRASTIM, R-METHUG-CSF)

After radical vulvectomy, infection and wound breakdown occurs in appr oximately 40-60% of patients resulting in significant morbidity and in creased hospital stay. Wound breakdown is primarily due to infection o f and tension on the wound. Post-operative defects in the immune syste m and neutrophil dysfunction map contribute to the high rate of this c omplication. To investigate this phenomenon in patients with a known h igh risk for postoperative infection, we studied the effect of filgras tim on primary or secondary wound healing (surgical wound breakdown) - per incisional side - in women requiring radical vulvectomy and ingui no-femoral lymphadenectomy (RVIFL). The results were compared with a h istorical control group and indicate a reduction in the rate of surgic al wound breakdown. Besides the clinical importance of decreasing the incidence of wound infection and tissue breakdown on patients quality of life, the benefits in terms of social-economic impact (days of hosp italization, post-operative nursing care health care budget) should al so be taken into account.