PARTIAL WOUND CLOSURE AFTER SURGICAL-CORRECTION OF EQUINOVARUS FOOT DEFORMITY

Full correction of severe equinovarus foot deformities is frequently l ost at the end of surgical release when the surgeon closes the skin in cision. We retrospectively review 31 feet in 22 patients whose medial skin incisions were left open (typically 10 mm) to heal by secondary i ntention. The criterion to leave a wound open was if primary closure w ith the foot in full correction might compromise circulation to the sk in or if closing the incision would require loss of corrected position . One or two cast changes were performed under outpatient anesthesia a t 7- to 14-day intervals for wound care. All wounds except one were he aled by week 6 at time of outpatient clinic cast removal. The appearan ce of the incisions is similar to feet in which primary closure is pos sible. One foot required split-thickness skin grafting at 3 weeks post operatively to achieve wound coverage. There were no infections. We co nclude that primary skin closure is not essential after surgical corre ction of equinovarus foot deformity, and that correction need not be c ompromised to approximate skin.