Chronic sinus formation using non absorbable braided suture following open repair of Achilles tendon

This study reports a case of a 34 year old man who sustained an Achilles tendon rupture which was surgically repaired using a non-absorbable suture that was complicated by a deep sinus and chronic infection. Despite antibiotics, surgical debridement and skin grafting, his condition did not resolve. Further imaging revealed a sinus leading to the core suture knot that was eccentrically placed but not buried within the healed tendon repair, and the offending suture was subsequently removed. This case highlights the importance of meticulous surgical technique when performing Achilles tendon repair and a high index of suspicion for early imaging when patients present with chronic wound infection post-operatively. The authors urge surgeons to use routinely use an absorbable non-braided suture, which remains buried within the core when performing Achilles tendon repair.