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The use of myocutaneous flaps for the treatment of pelvic pressure sores is well accepted, yet there are still unanswered questions about why myocutaneous flaps are clinically superior to skin flaps. An experiment involving 16 pigs revealed new data on the diffusion of infection through myocutaneous and cutaneous flaps, showing that the muscles can act as a barrier against such infection. In 51 patients seen consecutively in 1988, osseous specimens of the infected bottom of the decubital ulcers were taken. There was florid osteomyelitis in 65.9% of all specimens, further emphasizing the importance of muscle flaps in the treatment of pelvic pressure sores when infection is still present. The fate of 16 transposed gluteus maximus muscles was monitored by electromyography postoperatively; 15 still showed voluntomotoricity up to 7 months after transposition.
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