Patients with prepatellar septic bursitis are typically successfully managed nonoperatively with rest, compression, immobilization, aspiration, and antibiotics. Rarely, surgical excision of the bursa may be required for recalcitrant cases. Prepatellar bursectomy, however, has been associated with considerable risk of surgical-site morbidity. Although skin necrosis is frequently cited as a complication of open bursectomy, there is limited information in the medical literature on the etiology and management of this rare but serious complication.