Incidence of Wounds Associated with Posterior Midline Incision for Achilles Tendon Pathology in a Large Cohort at a...

We sought to determine the wound complications associated with a straight midline incision overlying the Achilles tendon. Data on sex, age, body mass index (BMI), surgery performed, date of surgery, and wound development were collected.

We retrospectively collected data on 217 patients with a mean ± SD age of 46.16 ± 13.72 years and follow-up of 9.1 ± 12.42 months. The specific procedures performed with this incision included repair of ruptured Achilles tendon (n = 89), Haglund deformity correction (n = 75), and flexor hallucis longus tendon transfer (n = 63). Wound complication was defined as a delay in wound healing with necrosis of the incisional margins resulting in exposure of superficial or deep layers. Deep infection was defined as the need for intravenous antibiotics.

We reported 15 wound complications (6.91%): ten (4.6%) were superficial and five (2.3%) were deep. All five patients with deep wound complications required operative debridement, and four patients required intravenous antibiotics. The infection rate of the midline incisional approach was 1.83%. Superficial wound complications were treated with local care and oral antibiotics, as necessary. There were no significant differences between age (P = .5986; P < .05), BMI (P = .7968; P < .05), smoking history (P = .6356; P < .05), or length of follow-up (P = .8338; P < .05). The overall wound rate of 6.91% is comparable with other literature with larger cohorts.

These results will help us better educate surgeons about the risk of wound development with the posterior midline Achilles tendon incision.