Reconstruction of Defect Overlying the Achilles Tendon with Artificial Dermis (Terudermis(superscript ®)) and Skin Graft-A Case Report and Literature Review

Abstract

Background: Soft tissue injuries over the Achilles tendon area often result in wound infection, delayed healing, adhesion, and limitation range of motion of the ankle joint. Soft tissue defects over the Achilles tendon has typically been treated with local and pedicled flaps or free flaps. Artificial dermis with skin grafts are rarely used on exposed Achilles tendons. Terudermis(superscript ®), an artificial dermis, which was previously used in the reconstruction after oral surgeries can be used in the reconstruction for the defects overlying the Achilles tendon. Aim and Objectives: The purpose of this article is to investigate the clinical feasibility of Terudermis(superscript ®) combined with skin grafts in defects overlying the Achilles tendon. We also review the management options for the defects around the Achilles tendon. Materials and Methods: We present a 73-year-old uremic woman with a full-thickness contact thermal burn over her right Achilles tendon. The wound was complicated with extended-spectrum β-lactamase Pseudomonas aeruginosa infection because of inadequate wound care. After the debridement, there is a 10*5 cm sized soft tissue defect overlying an exposed Achilles tendon. Results: Staged operation with the use of Terudermis(superscript ®) and then with skin grafting were performed in this patient. The skin grafts took well and there is minimal limitation in her ankle's range of motion. Conclusion: Terudermis(superscript ®) may serve as an alternative way of management for defects overlying the Achilles tendon. It is suitable for those who are not suitable for flap reconstruction. The operation time is shorter and there is no excessive tissue after the operation. It achieved good functional and aesthetic outcome.