Ulcers over the Achilles tendon

This is another notoriously difficult site to heal. It is an unusual site for ulceration and is usually triggered by unsuitable footwear or is a pressure lesion in an immobile patient. When tendon is exposed in the base of the ulcer the advice of a surgeon should be sought. Our colleague, E. Maelor Thomas, a founder member of our foot clinic and an orthopaedic surgeon, always said that dead tendon was the worst kind of sequestrum and should always be excised from ulcers.

We have used Hyaff to encourage granulation over healthy tendon, and have applied Apligraf to close a clean ulcer overlying a tendon.

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