Schmuckler Jo
Kindred Hospital, Havertown, PA, USA.
Ostomy Wound Manage. 2008 Aug;54(8):50-3.
Electrical stimulation and other modalities are recommended for treatment of pressure ulcers in spinal cord injury patients but their use may be limited by clinical contraindications such as necrosis and infection. Acoustic pressure wound therapy can be used to address infection and has no known contraindications related to wound status. A retrospective nonconsecutive study was conducted involving five inpatients with sacral pressure ulcers and compromised mobility (spinal cord injury, ventilator/mobility dependency, or persistent vegetative state) treated with acoustic pressure wound therapy three times per week, 4 to 6 minutes per session, for 5 weeks to 5.5 months. Acoustic pressure wound therapy was administered until necrotic tissue was removed, granulation was complete, drainage resolved to moderate levels, and wound size was compatible with indications for high-voltage electrical stimulation. Within 1 to 4 weeks of starting acoustic pressure wound therapy, four out of five wounds with substantial yellow slough or eschar demonstrated 100% granulation tissue and wound area and volume decreased 71% to 97% and 75% to 99%, respectively. Subsequent treatments included electrical stimulation alone (three patients) or in conjunction with negative pressure wound therapy (one patient), and silver foam (one patient). Acoustic pressure wound therapy was found to be an effective option in preparing wounds for subsequent therapy.
电刺激和其他治疗方式被推荐用于治疗脊髓损伤患者的压疮，但它们的使用可能会受到坏死和感染等临床禁忌症的限制。声压伤口疗法可用于治疗感染，且与伤口状况无关的已知禁忌症。进行了一项回顾性非连续研究，纳入了5例骶部压疮且行动不便的住院患者（脊髓损伤、依赖呼吸机/行动不便或持续性植物状态），每周接受3次声压伤口疗法治疗，每次治疗4至6分钟，持续5周至5.5个月。进行声压伤口疗法直至坏死组织清除、肉芽形成完成、引流降至中等水平且伤口大小符合高压电刺激的适应症。在开始声压伤口疗法的1至4周内，5处有大量黄色腐肉或焦痂的伤口中有4处出现了100%的肉芽组织，伤口面积和体积分别减少了71%至97%和75%至99%。后续治疗包括单独使用电刺激（3例患者）或与负压伤口疗法联合使用（1例患者），以及使用银泡沫敷料（1例患者）。结果发现，声压伤口疗法是为后续治疗准备伤口的有效选择。
