Management of diabetic foot abscess

The pictures show the management of a 30-year-old patient with a diabetic foot infection. The patient presented with a five-day history of ankle swelling, fever, and chills. At the time of incision and drainage, a large deep abscess was found within the ankle joint.
Following debridement, the skin and soft tissue defect involved the anterior and lateral lower leg (A). The extensor tendons were exposed (B), and following interim care with wound dressings, a free flap was used to cover the anterior ankle defect (preferred to prevent later joint contracture), and a split-thickness skin graft was placed on the lateral wound (C). Four weeks postoperatively, the wounds were healed and the patient was able to ambulate without difficulty (D).