Hyperbaric oxygen therapy following radical vulvectomy: an adjunctive therapy to improve wound healing.

The objective of the study was to evaluate the effect of postoperative hyperbaric oxygen (HBO) therapy on wound breakdown following radical vulvectomy. A prospective, observational study was performed on patients undergoing radical vulvectomy from October 1990 to March 1993 at Scott and White Memorial Hospital, Temple, Texas. HBO therapy was initiated in the postoperative period. Retrospective review of all patients coded as radical vulvectomy from 1987 to 1990 provides for a historical comparison. Eight patients were enrolled in the study. Six patients had radical vulvectomies with lymph node dissections (LND) and two did not. One wound breakdown was observed in the HBO-treated patients. Retrospective review identified 22 patients as having undergone radical vulvectomy with or without LND. Seven of 9 patients with LND and 3 of 13 without LND had wound breakdowns. A significant difference (P = 0.035) was found comparing patients treated with LND and HBO to retrospective controls with LND. Hospitalization was shorter in the HBO-treated patients. This small study showed a reduction in wound breakdown for patients undergoing radical vulvectomy with LND and HBO therapy compared to similar patients not treated with HBO. This observation supports the need for randomized studies examining the efficacy of HBO therapy in this group of patients.