Voigt Jeffrey, Wendelken Martin, Driver Vickie, Alvarez Oscar M
Medical Device Consultants of Ridgewood LLC, 99 Glenwood Road, Ridgewood, NJ 07450, USA.
Int J Low Extrem Wounds. 2011 Dec;10(4):190-9. doi: 10.1177/1534734611424648.
Ultrasound as a therapeutic agent in chronic wound healing has been studied extensively. This systematic review and meta-analysis specifically examines low-frequency (20-30 kHz) ultrasound delivered at either low or high intensity. The objective of this review was to determine whether low-frequency ultrasound used as an adjunctive therapy improves the outcomes of complete healing and reduction of size of chronic lower limb wounds. PubMed, Cochrane/CENTRAL, technical assessment, relevant wound-related journals, and clinical guidelines were searched along with contacting manufacturers and authors of relevant randomized controlled trials were completed. Searches focused on the use of low-frequency ultrasound in randomized controlled trials. Data were collected via a data collection form and was adjudicated independently via coauthors. Meta-analyses and heterogeneity checks were performed using Mantel-Haenszel and inverse variance (fixed and random effects) statistical methods on studies with similar outcomes (complete healing and percent wound area reduction) over similar time periods. Single study results were reported via the statistical methods used in the study. Eight randomized controlled trials were identified. Results demonstrated that early healing (at ≤5 months) in patients with venous stasis and diabetic foot ulcers was favorably influenced by both high- and low-intensity ultrasound delivered at a low frequency-either via contact or noncontact techniques. However, the quality of the data may be suspect, especially for low-frequency low-intensity noncontact ultrasound because of significant biases. In patients presenting with either venous stasis or diabetic foot ulcers (Wagner classification 1-3), early healing appears to be facilitated by either low-frequency low-intensity noncontact ultrasound or low-frequency high-intensity contact ultrasound.
超声作为慢性伤口愈合的治疗手段已得到广泛研究。本系统综述和荟萃分析专门考察了以低强度或高强度施加的低频（20 - 30千赫）超声。本综述的目的是确定用作辅助治疗的低频超声是否能改善慢性下肢伤口完全愈合的结果并减小伤口尺寸。检索了PubMed、Cochrane/CENTRAL、技术评估、相关伤口相关期刊及临床指南，并与相关随机对照试验的制造商和作者进行了联系并完成了检索。检索重点是随机对照试验中低频超声的使用情况。数据通过数据收集表收集，并由共同作者独立判定。对在相似时间段内具有相似结果（完全愈合和伤口面积减小百分比）的研究，使用Mantel - Haenszel和逆方差（固定效应和随机效应）统计方法进行荟萃分析和异质性检验。通过研究所用的统计方法报告单个研究结果。共识别出八项随机对照试验。结果表明，对于患有静脉淤滞和糖尿病足溃疡的患者，通过接触或非接触技术以低频施加的高强度和低强度超声均对早期愈合（≤5个月时）产生有利影响。然而，数据质量可能存疑，特别是对于低频低强度非接触超声，因为存在显著偏差。对于患有静脉淤滞或糖尿病足溃疡（Wagner分级1 - 3级）的患者，低频低强度非接触超声或低频高强度接触超声似乎都有助于早期愈合。
