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Pathological scars can result in functional impairment, disfigurement, a psychological burden, itch, and even chronic pain. We conducted a systematic review to investigate the influence of incisional Negative Pressure Wound Therapy (iNPWT) on scarring. PubMed, EMBASE and CINAHL were searched for preclinical and clinical comparative studies that investigated the influence of iNPWT on scarring‐related outcomes. Individual studies were assessed using the OHAT Risk of Bias Rating Tool for Human and Animal studies. The body of evidence was rated using OHAT methodology. Six preclinical studies and nine clinical studies (377 patients) were identified. Preclinical studies suggested that iNPWT reduced lateral tension on incisions, increased wound strength, and reduced scar width upon histological assessment. Two clinical studies reported improved patient‐reported scar satisfaction as measured with the PSAS (1 year after surgery), POSAS, and a VAS (both 42, 90, and 180 days after surgery). Five clinical studies reported improved observer‐reported scar satisfaction as measured with the VSS, SBSES, OSAS, MSS, VAS, and POSAS (7, 15, 30, 42, 90, 180, and 365 days after surgery). Three clinical studies did not detect significant differences at any point in time (POSAS, VAS, and NRS). Because of imprecision concerns, a moderate level of evidence was identified using OHAT methodology. Preclinical as well as clinical evidence indicates a beneficial influence of iNPWT on scarring. Moderate level evidence indicates that iNPWT decreases scar width and improves patient and observer‐reported scar satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study was to analyse complications after surgical intervention on the vulva, especially with grafting of the vaginal epithelium, for the relief of dyspareunia in women with lichen sclerosus.Material and Methods: A case series of 23 women with histologically confirmed lichen sclerosus who underwent vulvar surgery because of disabling sexual dysfunction. Surgical care was provided in a university hospital (tertiary referral center) between 2008 and 2012. The interventions were posterior vestibuloplasty (perineoplasty), dehooding of the glans clitoridis and anterior vestibuloplasty with grafts of vaginal epithelium.Results: A posterior vestibuloplasty was performed in all 23 women. Short-term complications included postoperative infection with subtotal dehiscence of the advanced vaginal epithelium (n = 1), and reactivation of lichen sclerosus with the formation of bullae due to the postoperative discontinuation of dermatosteroid use (n = 1). The long-term complications included localized pain (n = 3); although the relation with the surgical intervention was unclear. Four women underwent dehooding of the glans clitoridis, all without complications. Anterior vestibuloplasty with a free full-thickness graft of vaginal mucosa was performed in five women. One woman underwent a second operation because of contraction and keratinization of the graft. The importance of estrogens for the condition of the graft was unclear.Conclusions: After reconstructive vulvar surgery in women with lichen sclerosus, issues such as infection, reactivation of the disease and pain require attention. The use of vaginal grafts in the repair of the anterior vestibule is a novel approach and deserves further exploration. [ABSTRACT FROM AUTHOR]