Original ArticleHistologic Characteristics of Vaginal Cuff Tissue From Patients With Vaginal Cuff Dehiscence
Section snippets
Materials and Methods
Twenty-one patients had VCD after robotic hysterectomy performed from 2006 to 2009 [2]. All of the original robotically assisted hysterectomies were performed using monopolar scissors or a spatula for colpotomy. Further, no adhesion barrier materials were used. During repair of dehiscence, distal portions of the anterior and posterior cuff were excised using a cold knife or scissors. Seven of these vaginal cuff tissue samples in paraffin-embedded blocks were identified from the Pathology
Results
Patients in the VCD and non-VCD groups were similar in age, body mass index, menopausal status, smoking status, and history of receiving hormone replacement therapy. All patients in the study group had vaginal cuff dehiscence after 6 weeks (range, 42–85 days) (Table 1). None of the patients in the VCD group had clinical evidence of hematoma, postoperative vaginal cuff cellulitis, or abscess.
Patients with VCD had significantly higher levels of acute and chronic inflammatory cells: neutrophils
Discussion
After injury, normal wound healing starts systematically with the process of hemostasis and immediate infiltration of neutrophils and macrophages. Lymphocytes migrate to the wound site within 24 hours to clear debris and produce cytokines, which attract fibroblasts and endothelial cells to initiate granulation tissue formation [6]. At 2 to 3 days after injury, the healing cycle changes from a predominantly inflammatory state to a reparative state. Timely progression of wound healing is highly
Acknowledgments
We thank Thomas Colby, MD, for reviewing the slides.
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Supported by Mayo Clinic Arizona CR5 grant (Internal Grant Funding).
The authors declare no conflicts of interest.
Dr. Klauschie is currently affiliated with Academic Urology and Urogynecology of Arizona, Sun City West, Arizona.
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