title: Wound breakdown after total ankle arthroplasty.
abstract: BACKGROUND
  Wound breakdown of the operative incision is commonly encountered as a complication following ankle replacement surgery. Healing problems can progress to full thickness necrosis of the skin and deeper tissues jeopardizing the ultimate retention of the implants leading to compromised patient outcomes.
  
  
  METHODS
  The medical records of 57 consecutive primary total ankle arthroplasties (TAA) were retrospectively reviewed after observing a higher than expected rate of wound-healing problems consistently involving the central third of the operative incision.
  
  
  RESULTS
  The rate of wound breakdown was 28% in this series. Analysis of various possible risk factors showed a statistically significant increase in rate of wound breakdown associated with smoking greater than 12 pack years, peripheral vascular disease, and cardiovascular disease.
  
  
  CONCLUSIONS
  Preoperative identification of patient risk factors associated with breakdown of the operative incision after TAA should improve outcome of the procedure. Screening of those patients with risk factors for wound breakdown is recommended prior to total ankle arthroplasty.
authors.affiliation: Orthopaedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA. whalen.joseph@mayo.edu
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Whalen
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Spelsberg
authors.forename: Peter
authors.initials: P
authors.lastname: Murray
mesh_terms: D000368:Aged; D000843:Ankle Joint; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000150:complications; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000453:epidemiology*; D013997:Time Factors; D014945:Wound Healing