Infiltrating Wound Vacuum-Assisted Closure With Topical Amphotericin for Mucormycosis Infection of the Achilles Tendon.

Abstract

The rarity and heterogeneity of mucormycosis make treatment variable, and no prospective or randomized clinical trials exist in plastic surgery literature. The use of wound vacuum-assisted closure in combination with the instillation of amphotericin B to treat cutaneous mucormycosis is not well documented. A 53-year-old man underwent left Achilles tendon reconstruction with allograft after a complete tear during exercise. About 1 week after the operation, he began having incisional breakdown later found to be secondary to mucormycosis infection, prompting presentation to an emergency department. The use of negative pressure wound therapy with wound vacuum-assisted closure and intervals of instilling amphotericin B facilitated infection control in this lower extremity mucormycosis infection. Patients with a localized mucormycosis infection may benefit from treatment with an instillation wound vacuum-assisted closure with topical amphotericin B as presented in this case study.