One-Step Approach for Infections After Achilles Tendon Open Repair: The Distally Based Peroneus Brevis Muscle Flap

Abstract

The aim of this single-center, retrospective study is to demonstrate the effectiveness of distally based peroneus brevis muscle flap as first therapeutic option for infections after Achilles tendon open repair. We retrospectively analyzed 14 consecutive patients with complete Achilles tendon rupture and developing surgical site infection after an attempt of open surgical repair. Every patient was reconstructed with distally base peroneus brevis muscle flap. The primary outcome was the return to work and the initiation of full weight-bearing. Secondary outcomes were complication rate and time needed to return to work. A review of the literature was conducted to better define the actual standard treatment. Each patient returned to work. No flap necrosis occurred. Two minor healing delays and one hematoma were reported. Median time to wound healing was 17 days (interquartile range [IQR] = 13-20). Median time to full weight-bearing was 52 days (IQR = 47-55). Median follow-up (FU) was 21 months. Distally based peroneus brevis flap is a safe treatment for surgical site infections after Achilles tendon rupture repair. Patients regained full weight-bearing after a median time of 52 days from the surgical reconstruction. No major complications were observed. This flap clearly emerges as first reconstructive option for complications after surgery of Achilles tendon region.

Efficacy of Flap-based Posterior Trunk Reconstruction after Vertebrectomy and Radiation Therapy: A Retrospective Cohort Study

“…Flap coverage has shown efficacy and safety [15][16][17] in complex defect reconstruction, offering a more viable solution compared to the use of other products such as dermal matrices. 18 Although different studies are available in the literature reporting the efficacy of flap coverage in defects of the posterior trunk and spine, [19][20][21][22][23][24][25][26][27] they all report the coverage of defects that cannot be closed primarily.…”

Risk factors and clinical characteristics of surgical site infections in athletes undergoing Achilles tendon repair surgery

“…This period is essential for early detection and intervention, which could significantly reduce the severity and progression of SSIs. 18 , 27 Intraoperative observations shed light on the specific pathophysiological mechanisms of different infections, offering opportunities to refine surgical techniques and postoperative care. This deeper understanding can lead to more effective prevention strategies and treatment protocols, ultimately improving patient outcomes and recovery processes.…”

“…Furthermore, the identified timeframe from surgery to infection onset provides a critical window for vigilant postoperative monitoring. This period is essential for early detection and intervention, which could significantly reduce the severity and progression of SSIs 18,27 . Intraoperative observations shed light on the specific pathophysiological mechanisms of different infections, offering opportunities to refine surgical techniques and postoperative care.…”

The triple conjoined scapular–latissimus dorsi–groin flap for reconstruction of long lower extremity degloving injury: A case report

“…Considering the site of the injury, a free flap was the only option. Local muscle flaps for tendon coverage of the ankle and the foot (Vaienti et al, 2020) would have been only a partial solution to the defect. Conventional workhorse flaps, such as myocutaneous free LD flap, was the main choice for the coverage of the knee.…”