Ten patients with multiple sclerosis who had severe flexion contractures of the lower extremity ranging from 120 to 180 degrees were treated for large pressure sores. Each patient had at least one pressure sore in the sacral, greater trochanteric, or ischial areas. It was necessary to perform a tendon release procedure of the knee joint prior to addressing the problem of the pressure sores. Prior to treatment all patients were unable to utilize a wheelchair owing to their condition. Subsequent treatment, including development of skin flaps and skin grafts, postoperative casting, and immobilization in a special lamb's wool sling, allowed all 10 patients to improve to the point where they could utilize a wheelchair, with the result that their self-images improved.
Forty tissue samples, primarily of skin and bone, were obtained from 29 patients undergoing excision of decubitus ulcers after intravenous injection of 600 mg of clindamycin. Antibiotic concentrations exceeded 2.5 μg/g in 80% of the samples. In 50% of the instances, tissue levels were greater than those simultaneously present in the serum.
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