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 (2018–2022) 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 1.1–1.2). 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.

This study presents a case of a patient with a 6-month history of progressively worsening paresthesia, numbness, weakness, and shooting pain in the ulnar nerve distribution of the left hand. Ultrasound measurements showed an enlarged cross-sectional area of the ulnar nerve, confirming the diagnosis, and an isoechogenic and homogenous mass alongside the ulnar nerve. An open cubital tunnel release was performed for ulnar nerve decompression. Intraoperatively, a perineural lipoma was identified within the cubital tunnel and subsequently confirmed by histopathological analysis. Soft tissue lipomas rarely cause symptomatic compressive neuropathy. Although other space-occupying lesions within the cubital tunnel are well-documented in the literature, a perineural lipoma causing extrinsic ulnar nerve compression has not been previously reported. After surgery, shooting pain resolved, sensation normalized in digits four and five, and hand strength gradually improved. Therefore, we report the first case of a perineural lipoma extrinsically causing ulnar nerve compression in the cubital tunnel.