Context: Pelvic region pressure sores often develop following spinal cord injury. Surgery is often necessary for long standing, large-sized pressure sores not responding to conservative treatment. Authors analyze their results of a 10-year period, and identify factors contributing to the reduction of the recurrence rate. Methods: A total of 119 pressure sores were operated on 98 patients in two institutions during a 10-year period (1 January 2003 to 31 December 2012). The encountered perioperative complications are summarized, and the recurrence rate is analyzed with a patient follow-up questionnaire. Results: We experienced 15 perioperative complications (12.6%). All complications were fully resolved by conservative treatment. Fifty-eight returned patient replies were processed. The average follow-up time after surgery was 5.2 years. The recurrence rate was 5.47%. Conclusion:The strict adherence to surgical indications, full patient compliance, specialized pre-and postoperative patient care, our routinely used preferred surgical method, all contribute to a low post-operative complication rate, long-term flap survival, and an extended recurrence free period.

Introduction: The results of two spiroergometric measurements are presented that were taken from a spinal cord injured patient who participated in FES cycling training sessions for 11 months. Methods: The two measurements were taken 4 and 11 months after starting the training program. We investigated the respiratory exchange ratio (RER) and ventilation (VE/VO2, VE’/VCO2) ratios and the cycling cadence in the two investigated training sessions. Results: In the first assessment, the RER was below 1, which is the anaerobic training limit. Seven months later, in the second assessment, the RER value exceeded the anaerobic limit a few times and remained above it at the end of the session. The VE /VO2 and VE/VCO2 curves did not intersect during the first assessment. In the second one, the VE/VO2 and VE/VCO2 curves intersected several times and the oxygen quotient curve exceeded the carbon dioxide quotient curve. The patient achieved a low but similar cycling speed during the two assessments. Conclusion: Through the activation of paralyzed muscles with FES cycling we are able to train the paraplegic patient in aerobic and anaerobic training zones. This is shown by the value of RER, which reached the anaerobic training limit during the second assessment and remained in the anaerobic range for longer time.

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