Background: The Achilles tendon is commonly operated on, but has associated wound complications, ranging from 7–14% in previously reported series larger than 100 cases.

Methods: A retrospective review of one surgeon’s practice was conducted to assess the prevalence of wound complications associated with acute and chronic rupture repair, peritenolysis, tenodesis, debridement, retrocalcaneal exostectomy/bursectomy, and management of calcific tendinopathy of the Achilles tendon. The study evaluated the incidence of infection, and other wound complications such as suture reactions, scar revision, hematoma, incisional neuromas and granuloma formation.

Results: A total of 219 surgical cases were available for review (140 males, 70 females; average age at the time of surgery: 46.5 ± 12.6 years, range 16–75). Seven patients experienced a wound infection, three had keloid formation, six had suture granulomas, and six had suture abscesses, with an overall complication rate of 22 of 219 surgeries (10.1%). There were no hematomas. Seven patients had additional surgery following their wound complications; some had simple granuloma excision, while one necessitated a flap.

Conclusion: Knowledge of suture materials, proper incision placement and possibly avoiding tourniquet usage can keep complications low when performing Achilles tendon surgery. Regardless, some complications with Achilles tendon surgery may be unavoidable.