Partial wound closure after surgical correction of equinovarus foot deformity using a synthetic skin substitute

We retrospectively reviewed the results of partial wound closure after surgical release of severe equinovarus deformity in forty-eight (48) feet in thirty-two (32) patients. Epigard^®, a commercially manufactured synthetic skin substitute was used as a temporary coverage medium. The decision to perform synthetic skin substituted partial closure was made intraoperatively, if primary closure with the foot in the corrected position threatened circulatory compromise, or loss of correction. We did not find it necessary to deviate from our usual protocol of 6 weeks of postoperative casting, with one cast change at 3 weeks for hardware removal. There were no infections. No feet required grafting or other secondary procedures, including dressing changes. We conclude that synthetic skin substituted partial wound closure is a viable alternative after surgical correction of the severe equinovarus deformity. This technique avoids the inconvenience of frequent cast changes or uncovered partial wound closure, and the expense and increased surgical risk of skin grafting and rotational flap techniques.