Salvage technique for postoperative infection and necrosis of the Achilles tendon

Surgery of the Achilles tendon is associated with postoperative morbidity related to wound healing. Necrotic infection of the tendon is a rare but serious complication that may be associated with increasingly invasive surgical treatments using various free flap transfers proposed in the literature. Dealing with this complication, we prefer the technique of managed wound healing suggested by Dautry. The surgical procedure includes radical debridement of the infected tissue and necrotic Achilles tendon followed by managed wound healing with daily irrigation. Fifteen cases were treated between 1994 and 2003. Healing was achieved after 30 to 100 days. MRI results show scar tissue continuity suggesting a neotendon formation. Function was very satisfactory in 9/15 ankles. The salvage technique presented here for cases of infection and necrosis of the Achilles tendon is simple with low morbidity and results in effective wound and tendon healing with satisfactory functional and anatomical results.