Wound Complications Often Follow Vulvar Surgery for Premalignant Lesions

The American College of Obstetricians and Gynecologists remains uncertain about the value of prophylactic antibiotics before vulvar surgery for premalignant lesions. Investigators at a single U.S. academic center reviewed the records of 537 women (83% white, 65% cigarette smokers) who underwent such surgery; 42% received preoperative antibiotics (84% cefazolin).

Rates of wound complications (defined as dehiscence or infection) were similar among women who did or did not receive antibiotic prophylaxis (30.4% and 27.4%), as were rates of infection (7.5% and 6.5%). However, wound separation had shorter length in the antibiotic group (1 cm vs. 2 cm; P=0.03). In adjusted analyses, smoking and use of a reconstructive surgical flap remained signifi…