title: [Primary immediate coverage of decubitus ulcers by musculocutaneous flaps and gentamicin PMMA beads].
abstract: Myo- or fasciocutaneous flaps for coverage of longstanding pressure sores in para- or quadriplegic patients have been proved superior to cutaneous flaps. Pretreatment with ulcer-debridement and systemic antibiotics for urinary-tract-infection and septicaemia was thought to be necessary for successful closure of these difficult defects. In a prospective, clinical trial 17 patients with 20 pressure sores were treated this way during 1980-1983. From 1983-1985 no local or antibiotic treatment was given to a second group of 20 patients with 28 decubitus ulcers prior to a one-stage-closure of the pressure sores. Only five patients with septicaemia above 39 degrees C received antibiotics intraoperatively. Gentamicin-PMMA-beads were temporarily inserted under the myo- or fasciocutaneous flaps during the procedure. If necessary, urinary-tract-infection was treated after successful coverage. Both groups have been compared historically. There were less wound complications in the second group while a median time-saving of 2 1/2 weeks per patient could be gained, even though they had larger pressure sores, frequent bone involvement, and multiple ulcers in this group.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008768:Methylmethacrylates / Q000627:therapeutic use*; D008875:Middle Aged; D010264:Paraplegia / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology; D003668:Pressure Ulcer / Q000601:surgery*; D013524:Surgical Flaps; D014945:Wound Healing / Q000187:drug effects; D014946:Wound Infection / Q000601:surgery
chemical_list: D005839:Gentamicins; D008768:Methylmethacrylates; C030159:gentamicin-polymethylmethacrylate bead
vernacular_title: Der primär unverzögerte Verschluss chronischer Dekubitalulzera durch muskulokutane Lappen und Gentamicin-PMMA-Ketten.