title: Wound complications from surgeries pertaining to the Achilles tendon: an analysis of 219 surgeries.
abstract: BACKGROUND
  A retrospective review of one surgeon's practice was conducted to assess the prevalence of wound complications associated with acute and chronic rupture repair, peritenolysis, tenodesis, debridement, retrocalcaneal exostectomy/bursectomy, and management of calcific tendinopathy of the Achilles tendon.
  
  
  METHODS
  We evaluated the incidence of infection and other wound complications, such as suture reactions, scar revision, hematoma, incisional neuromas, and granuloma formation.
  
  
  RESULTS
  A total of 219 surgical cases were available for review (140 males and 70 females; mean +/- SD age at the time of surgery, 46.5 +/- 12.6 years; age range, 16-75 years). Seven patients experienced a wound infection, three had keloid formation, six had suture granulomas, and six had suture abscesses, for a total complication rate of 10.0%. Six patients had more than one complication; therefore, the percentage of patients with complications was 7.3%. There were no hematomas. Seven patients had additional surgery after their wound complications; some had simple granuloma excision, and one necessitated a flap. Patients with risk factors such as diabetes mellitus, smoking, and rheumatoid arthritis necessitating corticosteroid therapy were more likely to have a wound complication (Fisher exact test, P = .03).
  
  
  CONCLUSIONS
  Complications with Achilles tendon surgery may be unavoidable. Suture granulomas may appear in a delayed manner. Absorbable and nonabsorbable sutures can be implicated.
authors.affiliation: Department of Sports Medicine, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA. HeySax@aol.com
authors.forename: Amol
authors.initials: A
authors.lastname: Saxena
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.forename: Aidan
authors.initials: A
authors.lastname: Nguyen
authors.forename: Albert
authors.initials: A
authors.lastname: Li
mesh_terms: D000125:Achilles Tendon / Q000293:injuries / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006099:Granuloma / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology*; D013530:Surgical Wound Infection / Q000209:etiology*; D013536:Suture Techniques / Q000009:adverse effects; D013537:Sutures / Q000009:adverse effects; D052256:Tendinopathy / Q000209:etiology / Q000601:surgery*; D014481:United States