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

^* Podiatric Residency Program, Department of Surgery, Staten Island University Hospital, Staten Island, NY.

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

Abstract

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)