A 41-year-old man developed a 3 x 4 cm wound after corrective osteotomies of his distal tibia and fibula. The wound was debrided and covered with a free gracilis muscle flap. Seven days after flap transfer, the arterial pedicle ruptured adjacent to the anastomosis. Attempted repair of the aneurysm failed and the graft was subsequently debrided. Intraoperative wound cultures grew Pseudomonas and Enterobacter cloacae, which were attributed to formation of the aneurysm.
