Wound Dehiscence After Achilles Tendon Trauma and Repair: Treatment With Ultraportable Negative Pressure Wound Therapy and Compression Therapy

Abstract

Introduction. Achilles tendon rupture is a common injury requiring surgical repair. Re-ruptures, infections, delayed wound healing, and hematomas have been reported postoperatively. Objective. This case series described the use of ultraportable negative pressure wound therapy (NPWT) and compression bandaging following postoperative dehiscence of Achilles tendon repair. Materials and Methods. Retrospective records were reviewed to identify patients who underwent wound management for Achilles tendon dehiscence between January 2014 and January 2018. Patient demographics, wound size at first and last visit, number of visits, and previous treatment data were extracted. Wound management included wound irrigation, surgical debridement, and application of silver dressings, as needed. Therapy was transitioned to ultraportable NPWT with twice-weekly dressing changes. When possible, patients with an ankle-brachial index greater than 0.8 received multilayer, multicomponent compression. Treatment response was evaluated using a wound imaging system at 2-week to 4-week intervals for a total of 24 weeks. Results. Nine male patients with a mean age of 69.7 years presented for care. One patient sustained injury during sports activities, and the other 8 patients sustained injuries resulting from household accidents. Six patients achieved complete wound closure. Three patients achieved a mean 90% wound closure. No adverse effects were observed during treatment with NPWT and compression therapy. Conclusions. In the current study, ultraportable NPWT and compression bandaging were found to be effective in the management of wounds with critical local vascularity. Larger, randomized controlled studies are necessary to fully assess the potential clinical benefit of NPWT and compression therapy in the management of postoperative wounds of the Achilles tendon.