Use of Piscine Graft for a Surgical Wound After Postoperative Infection with Exposed Hardware

Background: A 67 year old male with a history of obesity, alcohol abuse and COPD presented status post forefoot reconstructive procedure presented with a postoperative infection & dehisced incision site with exposed hardware. Patient was admitted for sepsis and was started on IV antibiotics.  

Methods: An incision and drainage was performed with placement of vancomycin impregnated antibiotic beads. Six days later he was taken back to the operating room for irrigation and debridement, removal of antibiotic beads, excision of necrotic tendon, and the first application of a piscine graft. Three weeks and 5 weeks later, a second & third graft application was performed.

Results: Complete wound healing with minimal scar contracture was obtained 107 days after the original piscine graft application. There was no recurrence of infection.

Conclusion: Piscine graft is an effective tool for post-operative infection with wound dehiscence down to exposed hardware and bone.