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. 2021 Jan 26;7:559450. doi: 10.3389/fsurg.2020.559450

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Copyright © 2021 Desvigne, Bauer, Holifield, Day, Gilmore and Wardman.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Reconstruction of a non-healing lower extremity surgical defect. Case 3—(A) Thirteen-month-old non-healing defect following open reduction and internal fixation surgery of the left ankle. (B) Surgical excision of proximal chronic tissues and placement of the ECM graft into the defect. (C) Flap advancement and closure. (D) The defect exhibited signs of infection and secondary dehiscence 1-week post-surgery and was treated with a second ECM graft. (E) At 6 weeks, the defect demonstrated marked improvement with healthy granulation tissue development. (F) Successful closure of the defect by secondary intention was achieved 8-weeks after the initial flap reconstruction without additional surgical intervention.