Emsen Ilteris Murat
Numune State Hospital, Department of Plastic and Reconstructive Surgery, Erzurum, Turkey.
Burns. 2007 May;33(3):369-71. doi: 10.1016/j.burns.2006.08.007. Epub 2007 Jan 16.
Ultrasound is commonly used by physical therapists, but there is no consensus regarding the most effective therapeutic dose for accelerating healing of open or closed wounds. Now, the effect of therapeutic ultrasound on the formation of new blood vessels in full-thickness excised lesions in the flank skin of adult rats has been assessed quantitatively using microfocal X-ray techniques.
To investigate this, 30 rats were divided into three groups of 10 animals: a control group and two treated with ultrasound groups. Random dorsal skin flaps were elevated on the rats. In the control group, no operative procedures agents were used. Of the two treated groups, group 1 were exposed to pulsed ultrasound (2 ms on, 8 ms off) at an intensity of 0.1 W cm(-2) SATA (frequency either 0.75 MHz or 3.0 MHz). Group 2 exposed to pulsed ultrasound (2 ms on, 8 ms off) at an intensity of 0.18 W cm(-2) SATA (frequency either 0.75 MHz or 3.0 MHz), respectively.
The areas of flap necrosis were measured in each group. The median lengths of flap necrosis of the groups were 79.3, 57.0, and 35.3 mm, respectively. There was a statistically significant improvement of flap necrosis in ultrasound-treated groups compared with the control group (group 2, p=0.001; group 3, p=0.001). Furthermore, there was less necrosis in the high intensity ultrasound-treated group than the low intensity-treated group.
Ultrasound may have an intensity-dependent effect to increase flap survival in random skin flaps.
物理治疗师常用超声波,但对于加速开放性或闭合性伤口愈合的最有效治疗剂量尚无共识。目前,已使用微焦点X射线技术定量评估了治疗性超声波对成年大鼠侧腹皮肤全层切除损伤中新生血管形成的影响。
为研究此问题,将30只大鼠分为三组,每组10只动物:一组为对照组,两组为超声治疗组。在大鼠身上掀起随机的背部皮瓣。对照组未使用任何手术操作剂。在两个治疗组中,第1组暴露于强度为0.1W/cm² SATA(频率为0.75MHz或3.0MHz)的脉冲超声波(开2ms,关8ms)。第2组分别暴露于强度为0.18W/cm² SATA(频率为0.75MHz或3.0MHz)的脉冲超声波(开2ms,关8ms)。
测量每组皮瓣坏死面积。各组皮瓣坏死的中位数长度分别为79.3、57.0和35.3mm。与对照组相比,超声治疗组的皮瓣坏死有统计学显著改善(第2组,p = 0.001;第3组,p = 0.001)。此外,高强度超声治疗组的坏死比低强度治疗组少。
超声波可能具有强度依赖性效应,可提高随机皮瓣的皮瓣存活率。