BACKGROUND
Puncture injuries of the pediatric foot can lead to deep soft-tissue infections with substantial morbidity, often requiring complex surgical management or reconstructive procedures. Although negative pressure wound therapy (NPWT) is widely used in adults, its use in children remains limited, and reports of its use as definitive treatment for pediatric foot infections are rare.
CASE REPORT
We report the case of a 5-year-old girl who developed a severe plantar soft-tissue infection after stepping on a rusted nail. Radiographic evaluation excluded retained foreign material, whereas magnetic resonance imaging findings were suspicious for possible early osteomyelitis of the calcaneus. She was treated with intravenous antibiotics for a total of 6 weeks, along with tetanus immunoglobulin. Wound cultures grew methicillin-sensitive Staphylococcus aureus. Surgical debridement was performed down to the tarsal bones, with removal of extensive necrotic tissue, including the fibularis brevis tendon. Postoperatively, NPWT was applied, with dressing changes twice weekly for 1 month. The wound demonstrated progressive granulation tissue formation and gradual reduction in size, ultimately achieving complete closure within approximately 2 months without the need for skin grafting or reconstructive surgery. At follow-up, the patient was pain-free, fully weight-bearing, and had full passive range of motion in the foot and ankle. Although active eversion was lost due to tendon sacrifice, no functional limitation or gait disturbance was observed.
CONCLUSIONS
This case suggests that NPWT, combined with timely and adequate debridement, may serve as component of definitive treatment for deep pediatric foot infections, potentially avoiding reconstructive procedures in selected patients.

Keywords: Debridement; Foot; Negative-Pressure Wound Therapy; Pediatrics; Soft Tissue Infections; Wound Healing