{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:24:54Z","timestamp":1790112294273,"version":"4.0.1"},"reference-count":39,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objective: Vulvar cancer surgery is associated with high postoperative wound complication rates. Reconstructive surgery (RS) in vulvar cancer is generally reserved for surgery of extensive tumors or local recurrences. The primary aim of the study is to determine the incidence and risk factors for wound complications after vulvar cancer surgery. As a secondary aim, we compare the effects of primary closure (PC) versus reconstructive surgery on wound complications. Methods: In a retrospective cohort study in four gynecologic oncology centers in the Netherlands, patients undergoing surgical treatment (2018\u20132022) for vulvar cancer were included. Wound complications after PC and RS and risk factors associated with complications were analyzed by using logistic regression adjusting for confounds. Results: We included 394 women, 318 with PC and 76 with RS. The incidence of wound complications was 46.7%, with 42.4% of wound breakdowns comprising the majority of complications. The use of RS was associated with an increased risk of wound complications. Larger tumor size, proximity to the urethra, resection of the urethra during surgery, and perineal tumor location were additional risk factors for wound complications. However, after multivariate analyses, RS remained the only significant risk factor (OR 1.2; 95% CI 1.1\u20131.2). Conclusions: Risk factors for wound complications after vulvar cancer surgery include larger tumor size, proximity to the urethra, resection of the urethra during surgery, and perineal tumor location. RS is also associated with an increased risk of wound complications, probably related to case selection.<\/jats:p>","DOI":"10.3390\/cancers17111749","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T06:35:09Z","timestamp":1747982109000},"page":"1749","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Risk Factors for Wound Complications in Vulvar Cancer Surgery and Indications for Reconstructive Surgery"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1092-8089","authenticated-orcid":false,"given":"Justin J. E.","family":"Delahaije","sequence":"first","affiliation":[{"name":"Department of Gynecology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands"},{"name":"Department of Plastic and Reconstructive Surgery, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7871-5884","authenticated-orcid":false,"given":"Ephrahim E.","family":"Jerry","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8680-1380","authenticated-orcid":false,"given":"Saskia","family":"Houterman","sequence":"additional","affiliation":[{"name":"Department of Research, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"van Woerkom","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doremieke","family":"van Loosdregt","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9673-7845","authenticated-orcid":false,"given":"Dorry","family":"Boll","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte F. M.","family":"Slangen","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Maastricht University Medical Center, 6229 ET Maastricht, The Netherlands"},{"name":"GROW\u2014School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4577-8495","authenticated-orcid":false,"given":"Ruud L. M.","family":"Bekkers","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands"},{"name":"Department of Gynecology, Maastricht University Medical Center, 6229 ET Maastricht, The Netherlands"},{"name":"GROW\u2014School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, The Netherlands"},{"name":"Department of Gynecology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy J.","family":"De Vos van Steenwijk","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Maastricht University Medical Center, 6229 ET Maastricht, The Netherlands"},{"name":"GROW\u2014School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne A.","family":"de Hullu","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0674-9405","authenticated-orcid":false,"given":"Annemijn J. W. M.","family":"Aarts","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cancer Center Amsterdam, Amsterdam University Medical Centers, Vrije Universiteit Medisch Centrum, 1081 HV Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4538-6750","authenticated-orcid":false,"given":"Emiel L. W. G.","family":"van Haren","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7387-5922","authenticated-orcid":false,"given":"Edith M. G.","family":"van Esch","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"ref_1","unstructured":"Capria, A., Tahir, N., and Fatehi, M. (2024, July 14). Vulva Cancer, StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK558950\/."},{"key":"ref_2","unstructured":"Integraal Kankercentrum Nederland (IKNL) (2024, July 14). Vulvacarcinoom, Landelijke Richtlijn. Available online: https:\/\/richtlijnendatabase.nl\/gerelateerde_documenten\/f\/5532\/IKNL%20richtlijn%20Vulvacarcinoom%20(15-01-2018).pdf."},{"key":"ref_3","unstructured":"(2024, July 14). Netherlands Cancer Registry. 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