Piscine Xenograft Utilization for Surgical Dehiscence Following Achilles Tendon Rupture Surgery: A Case Report

Introduction: Augmented repairs of the Achilles tendon can lead to increased rate of wound complications and infection due to the more extensive approach.  Methods for the reconstruction of soft tissues after infection have been presented in the literature, but the results have been variable and there is insufficient data in general to support any of the techniques. Effective management of these complications is crucial for optimal recovery and function. Piscine xenografts, derived from fish skin, offer promising potential due to their biocompatibility and regenerative properties that facilitate rapid cell ingrowth and create a natural bacterial barrier enriched with Omega-3 fatty acids. This case report examines the use of piscine xenografts in managing postoperative dehiscence following Achilles tendon reconstruction with a gastrocnemius aponeurosis turndown flap augmentation.Methods:A 68-year-old male patient with an acute Achilles tendon rupture underwent Achilles tendon repair with FHL tendon transfer and a gastrocnemius aponeurosis turndown flap augmentation. Postoperatively, the patient developed significant wound dehiscence. The patient was taken for surgical debridement with application of piscine xenograft subdermally for soft tissue defect repair/augmentation. The patient was monitored for integration of the graft, signs of infection, and progress of wound healing. Follow-up assessments were conducted over a six-month period.Results:The application of the piscine xenograft resulted in excellent integration with the surrounding tissue, with no adverse reactions or infections. Within two weeks, the incision demonstrated complete epithelialization with no dehiscence. The patient experienced minimal discomfort and exhibited no further complications. At six months, the site showed a well-healed, and the patient had returned to preoperative activity levels with full function of the Achilles tendon.Discussion: The successful outcome in this case underscores the potential of piscine xenografts as a viable option for managing postoperative wound dehiscence in Achilles tendon reconstruction. Their ability to integrate seamlessly with human tissue and promote rapid healing makes them an attractive alternative to conventional treatment methods. Further research involving larger cohorts and comparative studies is necessary to validate these findings and to optimize the use of piscine xenografts in surgical practice. This case report contributes to the growing evidence supporting the efficacy of innovative biological materials in enhancing postoperative recovery and reducing complications.References: