Chronic draining sinus tract treatment

The pictures show the management of a patient with a chronic draining sinus related to repair of a prior calcaneal fracture one year previously. Incision, drainage, debridement, and removal of infected hardware resulted in an anterior leg wound and lateral foot defect (A). An arteriogram showed perfusion to the foot via only the anterior tibial artery (B). A free gracilis muscle flap was placed into the defect with the anterior tibial vessels used as recipient vessels (C). The appearance of the healed free muscle flap is shown (D).