Final answer:
In a radical vulvectomy, layers including the skin, subcutaneous tissue, and deeper tissues are cut. Surgical counts of soft goods, sharps, and instruments are conducted after each layer is closed to ensure patient safety and that no foreign objects are left within the patient.
Step-by-step explanation:
A radical vulvectomy is a surgical procedure that involves the removal of the entire vulva, which can include the labia minora, labia majora, and possibly the underlying tissue such as part of the vagina, depending on the extent of the disease. During this procedure, multiple layers are incised, which typically include the skin, subcutaneous tissue, and deeper tissues depending on the pathology. After the incision through each layer, hemostasis is ensured before proceeding further.
Concerning surgical counts, the process is critical for ensuring that no foreign objects remain inside the patient post-surgery. After closure of each layer, the surgical team performs counts for soft goods (like sponges), sharps (such as needles), and instruments. These counts are essential for patient safety and are generally conducted after the closure of each layer, as well as at the completion of the surgical procedure. Proper documentation and communication within the surgical team are vital to the success of these safety checks.