Conservative Management of Wound Dehiscence Following Pediatric Cavus Foot Surgery: A Case Series

BACKGROUND: Cavus foot surgeries are relatively common procedures in pediatric orthopedics. Following surgery, the tensile forces exerted on the wound by the newly corrected foot may hinder soft tissue healing and lead to wound dehiscence. Treatments including skin grafting and other plastic surgery procedures have been described in order to manage this complication. However, the effectiveness of conservative treatment regimens in cases of large dehiscence of these wounds has not yet been reported. METHODS: The charts of 7 patients between the ages of 7 and 19 who had surgical correction of severe cavus deformity and who developed wound dehiscence postoperatively were reviewed. All patients were treated conservatively with regular cleaning with chlorhexedine and application of different ointments and dressings along with surgical debridements. Three patients also received antibiotics. The primary outcome was wound healing as documented by clinical notes and photographs. RESULTS: The treatment was successful in producing the desired outcome in all cases with no other systemic or wound complications developing. Complete wound healing was obtained within a median time of 6 months and 5 days of treatment without the need for skin grafting or other plastic surgery procedures. CONCLUSIONS: In pediatric patients with wound dehiscence postcavus foot surgery, conservative management with minimal surgical debridement and regular cleaning and dressing of the wound is a viable treatment option that has been shown to be effective in 7 cases. It should be considered in such patients before proceeding to more invasive surgical treatment.