• 1

    Stapp MD, Taylor RP: “Edema, Hematoma, and Infection,” in McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery, ed by AS Banks, p 1997, Lippincott Williams & Wilkins, Philadelphia. ,2001. .

  • 2

    Cruse PHE, Ford R: The epidemiology of wound infection: a 10-year prospective study of 62,939 wounds. .Surg Clin North Am 60::27. ,1980. .

  • 3

    Hugar DW: “Management of Infection,” in American College of Foot Surgeons: Complications in Foot Surgery: Prevention and Management, ed by SA Marcus, BH Block, p 494, Williams & Wilkins, Baltimore. ,1984. .

  • 4

    Culver DH, Horan TC, Gaynes RP, et al: Surgical wound infection rates by wound class, operative procedure, and patient risk index: National Nosocomial Infections Surveillance System. .Am J Med 91::152S. ,1991. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Miller SJ: Surgical wound drainage system using silicone tubing. .JAPA 71::287. ,1981. .

  • 6

    Hunter RL: Transferrin in disease II: defects in the regulation of transferrin saturation with iron contribute to susceptibility to infection. .Am J Clin Pathol 81::748. ,1984. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Roth D: “Tissue Injury Due to Extravasated Blood,” in Surgical Bleeding, ed by AW Ulin, SS Gollum, p 71, Mc-Graw-Hill, New York. ,1966. .

  • 8

    Schwartz S: “Complications,” in Principles of Surgery, 4th Ed, ed by S Schwartz, p 458, McGraw-Hill, New York. ,1984. .

  • 9

    Cowan KN: Vacuum-assisted wound closure of deep sternal infections in high-risk patients after cardiac surgery. .Ann Thorac Surg 80::2205. ,2005. .

  • 10

    KCI: KCI Wound VAC Therapy: Clinical Guidelines: A Reference Source for Clinicians, KCI, San Antonio, TX, January. 2005. , pp 4–34.

  • 11

    Joseph E, Hamori CA, Bergman S, et al: A prospective, randomized trial of vacuum-assisted closure versus standard therapy of chronic non-healing wounds. .Wounds 12::60. ,2000. .

    • Search Google Scholar
    • Export Citation
  • 12

    Andros G, Armstrong DG, Attinger CE, et al: Consensus statement on negative pressure wound therapy (V.A.C. Therapy) for the management of diabetic foot wounds. .Ostomy Wound Manage (June):1. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Stannard JP, Robinson JT, Anderson ER, et al: Negative pressure wound therapy to treat hematomas and surgical incisions following high-energy trauma. .J Trauma 60::1301. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    EBI Medical: EBI DFS: A Guide to Operative Techniques, EBI Medical, Parsippany, NJ. ,2002. , p 1.

  • 15

    Roukis TS, Landsman AS: Salvage of the first ray in a diabetic patient with osteomyelitis. .JAPMA 94::492. ,2004. .

  • 16

    Seibert FJ, Fankhauser F, Elliott B, et al: External fixation in trauma of the foot and ankle. .Clin Podiatr Med Surg 20::159. ,2003. .

Negative-Pressure Wound Therapy and External Fixation for Infection and Hematoma After Hallux Abducto Valgus Surgery

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  • 1 Podiatric Residency Program, Department of Surgery, Staten Island University Hospital, Staten Island, NY.
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Hematoma refers to the collection or extravasation of blood, usually clotted, in a closed tissue space. It is caused by leakage from local vessels damaged by blunt trauma, local injury, or surgical dissection. In the postoperative phase, a hematoma often results in edema, pain, wound dehiscence, infection, and scarring of the surgical wound. We describe a 44-year-old woman who developed severe complications, including hematoma, abscess, failure of internal fixation, and loss of soft-tissue structures, after hallux abducto valgus surgery. Hospitalization was required for infection control, soft-tissue coverage through negative-pressure wound therapy, and first metatarsophalangeal joint stabilization through external fixation. Early recognition of the signs of infection and hematoma can help decrease the incidence of postoperative complications. (J Am Podiatr Med Assoc 97(5): 410–414, 2007)

Corresponding author: Laura Guerin, DPM, 970 Bard Ave, Staten Island, NY 10305.