Giant condyloma acuminatum is caused by the failure of some patients to receive timely diagnosis and treatment, delaying the treatment opportunity, or improper treatment measures, pregnancy, autoimmune diseases, organ transplantation and other natural or man-made factors, which make the human immune function in a low state, the disease is not under control, and the warts are overproliferated. It grows rapidly, forming a wart-like or cauliflower-shaped shape, which may cause necrosis and infection. The warts can be removed by laser and surgery. Compared with laser or traditional surgical wart removal, the use of suture ligation to treat giant condyloma acuminatum has the advantages of less damage, less bleeding, less postoperative pain, one-time complete removal of giant warts, intact appearance of the lesion site after healing, basically no scars, and low recurrence rate at the surgical site.
1. Contraindications
1. Severe infection.
2. Severe systemic diseases: abnormal coagulation function, etc.
2. Preoperative Preparation
Patients with infection should receive 3 days of anti-infection treatment before surgery, and use diluted povidone-iodine solution to sit on a basin and clean the vulva.
3. Anesthesia
Epidural block anesthesia.
4. Body Position
Lithotomy position of bladder.
5. Surgical steps
1. Look for easily separable wart lobes and pedicles in the perianal lesions.
2. Hold the wart pedicle with a vascular clamp close to the skin, then clamp the pedicle on it, and cut off the wart lobes along the vascular clamp, making the remaining pedicle as short as possible.
3. Suture and ligate the remaining pedicle. Insert the needle 0.2-0.3 cm near the base of the pedicle, deep into the dermis, and make a bag-shaped suture ligation around the pedicle.
4. Remove the giant warts lobes by lobes, and make sure to remove the anal wart lobes last.
5. Use a CO2 laser machine or an electronic multifunctional therapeutic device to completely remove the small warts scattered on the skin and mucous membranes around the giant condyloma acuminatum.
6. Check the vaginal, penile and rectal mucosa for warts and damage.
6. Postoperative treatment
1. Anti-infection treatment, povidone-iodine solution basin.
2. It is better to lie quietly.
3. Abstain from sexual intercourse for one month.
4. Antiviral and immune enhancement treatments can be given simultaneously.
Generally speaking, the residual pedicle begins to necrotize and fall off 7 days after the operation, and basically falls off completely in 2 weeks. Most of the sutures fall off along with the necrotic pedicle and do not need to be removed.
