Maher Sara F, Halverson Jessica, Misiewicz Rob, Reckling Trisha, Smart Ojas, Benton Carol, Schoenherr Dawn
Oakland University, Rochester, MI; email:
Oakland University, Rochester, MI.
Ostomy Wound Manage. 2014 Feb;60(2):52-61.
Low-frequency ultrasound may facilitate debridement and healing of chronic wounds, including lower leg wounds in patients with chronic venous insufficiency (CVI). To evaluate the use of a low-frequency ultrasound (LFU) device with a curette, two patients with CVI and chronic wounds were treated for a period of 2 to 3 weeks. A 63-year-old woman with rheumatoid arthritis and two wounds, one on the right lower leg (250 cm³) and one wound on the left medial leg (0.80 cm³), present for 12 months; and a 77-year-old man with cardiopulmonary issues with seven wounds, three on the left medial calf (1.2 cm³, 11.40 cm³, and 0.72 cm³), one on the left anterior calf (0.30 cm³), two on the right posterior calf (0.90 cm³, 0.30 cm³), and one on the right anterior calf (0.14 cm³), present for 3 months consented to participate in the study. Both patients received low-intensity (50-70 μm), low-frequency (35 kHz) ultrasound at an intensity of 50% through a saline mist in addition to antimicrobial dressing with silver, a multilayer compression bandage system applied at every visit, and pain medication as needed. Both patients received treatments every 1 to 3 weeks that were not timed. Treatment continued until no additional slough or other necrotic tissue could be removed from the wound bed; the female patient received two treatment sessions and the male received three. Average wound volume did not change significantly from the first to last treatment session (t(8)-1.2, P = 0.26). Five wounds (56%) with initial measurements of 0.8 cm³, 0.72 cm³, 0.3 cm³, 0.3 cm³, and 0.14 cm³ reduced in volume by 100%. Mean wound characteristic scores changed significantly (P <0.05) for amount of fibrin, periwound skin, drainage amount, and color. In addition, the number of wounds filled with slough decreased from 89% at the first session to 22% at the final treatment session. The results of this study suggest LFU may have been beneficial for these patients with CVI. Additional studies using larger sample sizes are needed to evaluate the effect of this treatment on a variety of chronic wounds and to compare its effectiveness to other debridement methods.
低频超声可能有助于慢性伤口的清创和愈合，包括慢性静脉功能不全（CVI）患者的小腿伤口。为了评估一种带有刮匙的低频超声（LFU）设备的使用效果，对两名患有CVI和慢性伤口的患者进行了为期2至3周的治疗。一名63岁患有类风湿性关节炎的女性有两处伤口，一处在右小腿（250立方厘米），一处在左小腿内侧（0.80立方厘米），已存在12个月；一名77岁患有心肺问题的男性有七处伤口，三处在左小腿内侧（1.2立方厘米、11.40立方厘米和0.72立方厘米），一处在左小腿前部（0.30立方厘米），两处在右小腿后部（0.90立方厘米、0.30立方厘米），一处在右小腿前部（0.14立方厘米），已存在3个月，他们同意参与该研究。两名患者除了接受含银抗菌敷料、每次就诊时使用的多层加压绷带系统以及必要时的止痛药物外，还通过盐水喷雾以50%的强度接受低强度（50 - 70微米）、低频（35千赫）的超声治疗。两名患者每1至3周接受一次不定时的治疗。治疗持续进行，直到伤口床不再有额外的腐肉或其他坏死组织可清除；女性患者接受了两次治疗，男性患者接受了三次治疗。从第一次治疗到最后一次治疗，平均伤口体积没有显著变化（t(8)-1.2，P = 0.26）。最初测量体积为0.8立方厘米、0.72立方厘米、0.3立方厘米、0.3立方厘米和0.14立方厘米的五处伤口（56%）体积减少了100%。纤维蛋白量、伤口周围皮肤、引流量和颜色的平均伤口特征评分有显著变化（P <0.05）。此外，充满腐肉的伤口数量从第一次治疗时的89%降至最后一次治疗时的22%。这项研究的结果表明，LFU可能对这些CVI患者有益。需要进行更多使用更大样本量的研究，以评估这种治疗对各种慢性伤口的效果，并将其有效性与其他清创方法进行比较。
