Unilateral vulvar edema after intraperitoneal Hyskon administration

Hyskon (Pharmacia Laboratories, Piscataway, NJ), a mixture of 32% wt/vol dextran 70 and 10% wt/vol dextrose to a volume of 100 ml, is commonly used as an adjunctive measure to human infertility surgery. Its intraabdominal instillation has been reported to reduce the incidence of surgical adhesions in several species of animals. With intraperitoneal use, the high molecular weight of dextran 70 creates an osmotic gradient, which attracts fluid into an osmotic gradient, which attracts fluid into the peritoneal cavity. This hydroflotation effect prevents the prolonged apposition of raw surfaces that may be predisposed to adhesion formation and is postulated to be its primary mechanism of action. Complications from the use of Hyskon are rare. We report here two cases of postoperative vulvar swelling after the intraperitoneal instillation of Hyskon, as the first detailed account of this complication.