Wound complicadons after open Achilles tendon repair - An analysis of risk factors

Operative treatment of Achilles tendon ruptures has the risk of wound complications. The purpose of this study is to determine the risk ratio for specific risk factors associated with wound related complications in patients with operatively treated Achilles tendon ruptures. Between 1978 and 2001, 167 open Achilles tendon repairs were done at our institution. Clinical data were retrospectively reviewed. Tobacco use, diabetes, age, gender, timing of surgery, body mass index and steroid use were evaluated as potential risk factors for wound healing complications. One patient was lost to follow-up and two patients had nonsimultaneous ruptures and only the first repair was included; the remaining patients were followed up until complete wound healing. There were 17 wound complications in 164 patients (10.4%). Significant risk factors for development of wound complications included tobacco use (p < 0.0001), steroid use (p = 0.0005), and female sex (p = 0.0400). For those patients who had one or more of the following risk factors: diabetes, tobacco use, or steroid use; eight of 19 (42.1%) had a complication, compared with nine of 145 (6.2%) for those without risk factors present (p < 0.0001). Surgeons doing open Achilles tendon repairs should be cognizant of the specific risk factors identired in this study, because they might impact decision making with regard to operative versus nonoperative treatment.