Byl N N, McKenzie A, Wong T, West J, Hunt T K
UCSF/SFSU Graduate Program in Physical Therapy, School of Medicine 94122.
J Orthop Sports Phys Ther. 1993 Nov;18(5):619-28. doi: 10.2519/jospt.1993.18.5.619.
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. A controlled, single-blind, posttest experimental study was carried out to compare differences in wound breaking strength and collagen deposition [hydroxyproline (HoPro)]. Forty-eight incisions were surgically induced in three mini Yucatan pigs. Each incision was randomly assigned to a control or an ultrasound treatment group with the sonated incisions further randomly assigned to 5 or 10 days of ultrasound treatment with either high dose ultrasound (HUS) (1.5 W/cm2, continuous mode, 1 MHz, 5 minutes) or low dose ultrasound (LUS) (0.5 W/cm2, pulsed mode, 20% duty cycle, 1 MHz, 5 minutes). Using the nonparametric two-sample Wilcoxon test, the breaking strength was found to be significantly higher in the sonated incisions compared with the control incisions (p < or = 0.02), but there were no significant differences in HoPro. For all groups, the level of HoPro measured the second week was significantly higher (an average of 60%) than measured the first week (p < or = 0.001). A significant interaction was found between the number of days of treatment and the dose of ultrasound. Hydroxyproline was significantly higher in the LUS group compared with the HUS group after 5 days of ultrasound. Both the wound breaking strength and the HoPro levels were significantly higher in the LUS group compared with the HUS group after 10 days of treatment (p < or = 0.02 and 0.01, respectively). The findings from this study suggest that physical therapists can use either LUS or HUS for approximately 1 week to enhance wound breaking strength in an acute incisional wound. However, if the goal is to continue to facilitate collagen deposition and wound strength, then a low dose of ultrasound should be used when treatment is continued for 2 weeks or more.
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。开展了一项对照、单盲、后测实验研究，以比较伤口抗张强度和胶原蛋白沉积[羟脯氨酸（HoPro）]的差异。在三只小型尤卡坦猪身上进行手术制造了48处切口。每个切口随机分配到对照组或超声治疗组，接受超声治疗的切口再随机分配接受5天或10天的超声治疗，采用高剂量超声（HUS）（1.5W/cm²，连续模式，1MHz，5分钟）或低剂量超声（LUS）（0.5W/cm²，脉冲模式，20%占空比，1MHz，5分钟）。使用非参数双样本威尔科克森检验发现，接受超声治疗的切口抗张强度显著高于对照切口（p≤0.02），但HoPro无显著差异。对于所有组，第二周测量的HoPro水平显著高于第一周测量的水平（平均高60%）（p≤0.001）。发现治疗天数和超声剂量之间存在显著交互作用。超声治疗5天后，LUS组的羟脯氨酸显著高于HUS组。治疗10天后，LUS组的伤口抗张强度和HoPro水平均显著高于HUS组（分别为p≤0.02和0.01）。本研究结果表明，物理治疗师可以使用LUS或HUS约1周来增强急性切口伤口的抗张强度。然而，如果目标是继续促进胶原蛋白沉积和伤口强度，那么在持续治疗2周或更长时间时应使用低剂量超声。
