Deep bone and soft tissue infections are among the most challenging orthopedic conditions to treat. Deep space infection and osteomyelitis of the foot and ankle are particularly difficult to manage, requiring repeated hospitalization and treatment [1], and recurrences reduce the treatment options [2]. Furthermore, these cases sometimes require amputation of the lower extremity [3,4]. The general treatment for infection is surgical debridement of the infected tissues and intravenous administration of antibiotics [5]. However, bacteria often form biofilms in intractable deep-foot infections. Eradication of mature biofilms requires an antimicrobial concentration of 100–1000 times the minimum inhibitory concentration [6]. Furthermore, due to its peripheral location, there is insufficient blood flow in the infected site and in the foot; hence, antibiotics do not sufficiently reach the tissues. Thus, it is difficult to achieve an effective treatment with systemic intravenous antibiotic administration [7]. On the other hand, local implantation of antibiotic-containing products has been found to be effective against bone and soft tissue infections [8]. The advantage of antibiotic-containing products is the local supply of antibiotics at concentrations higher than the minimum inhibitory concentration. However, the disadvantage is a decrease in the released antibiotics over time [9].

Recently, a new technique called continuous local antibiotic perfusion (CLAP), which continuously delivers high concentrations of antibiotics directly to the infected bone and soft tissue through tubes, has been reported [10]. CLAP theoretically differs from local implantation of antibiotic-containing products in that the local antibiotic concentration is maintained at a constant level. Some researchers have reported the clinical results of CLAP for chronic osteomyelitis [11], surgical site infection after spinal fusion [12], deep infection after osteosynthesis [13], and periprosthetic joint infection [14]. However, few studies have reported results of foot and ankle infections treated with CLAP. This study aimed to report the clinical results of deep foot and ankle infections after CLAP.