A Pilot Study of Ultrasonically-assisted Treatment of Residual Burn Wounds

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Xiaolu Li, MD, PhD; Shunli Liu; Xinan Lai, PhD; Gaoxing Luo, MD, PhD; Hong Yan, MD, PhD; Xianhui Huang; Yuesheng Huang, MD, PhD; Yizhi Peng, MD, PhD

Abstract: Objective. To evaluate the use of a noninvasive, low-frequency ultrasound device to treat residual burn wounds as an adjunct to regular wound dressing therapy. Methods. Nineteen patients with 38 residual wounds (served as self control) with an average post-burn duration of 94.6 days were recruited. Low-frequency ultrasound at 40 kHz was delivered in the ultrasonic group by a handheld probe, using normal saline as the irrigation medium. The control group had dressings changed with saline used as the coupling medium. Each wound was treated for 2 weeks (a total of 7 treatments; once every 2 days). Bacterial colony counts were done before the first and then after the fourth treatment. Serial color photographs were taken to evaluate the wound response at each visit. Healing time and percentage closure were determined. Results. Symptomatic relief (pain and odor reduction) was achieved in all patients. The healing percentage for the wounds treated with ultrasound was 100%. The healing rate in the treatment group was 84%, while the healing rate was 71.46% ± 31.06%; both were significantly higher compared to the control wounds (P < 0.01). The bacterial clearance rate in the ultrasound group (82.85 ± 19.13) increased significantly compared to the control group (35.55 ± 16.99). There were no major complications with the treatment, which was relatively painless. Conclusion. The application of low-frequency ultrasound treatment may heal residual burn wounds when a nonsurgical dressing change protocol has failed. The significant decrease in wound bioburden was definitely related to the use of the ultrasound treatment. No adverse reactions to the ultrasound treatment were found during the study.

Address correspondence to:
Yizhi Peng, MD, PhD and
Xiaolu Li, MD, PhD
Burn Unit, Southwest Hospital, Third Military Medical University
Chongqing, China 4000038
Phone: 86 159 2257 2258
E-mail: xiaolucn@163.com

     Residual wounds rarely heal spontaneously and are prone to reoccur, especially severe burns.1 Many forms of wound treatment have been applied to residual burn lesions including surgical, chemical, enzymatic, mechanical, and biological techniques.1 Experimental therapeutic ultrasound (at lower frequencies) as a means of wound treatment has seen promising results in hastening wound healing.2–4 Studies of ultrasound treatment in patients with venous ulcers showed a significant difference in healing with a nearly 40% improvement compared to a control.5,6

     The aim of this prospective pilot study was to evaluate the tolerability and effectiveness of low-frequency ultrasound in healing residual burn wounds as an adjunct to traditional wound dressing therapy.


     Patient selection. Residual burn wounds were defined as unhealed wounds 3 weeks after injury. Patients admitted to the Burn Unit (Southwest Hospital, Chongqing, China) between 18- and 60-years-old, both male and female, with no serious complications of the heart, liver, kidney, or blood system, and no serious systemic infection were recruited. Patients with diabetic ulcers were required to control their blood sugar levels at ≤ 10 mmol/L and to maintain this level for more than 2 weeks with no acute metabolic disorders. The Southwest Hospital Ethics Committee approved the study protocol. All patients willingly participated in the trial and gave informed consent.

     Nineteen patients who had residual burn wounds at least 2 months post injury were enrolled in the study. One patient was dropped from the study due to non-compliance with the protocol. All patients had more than two residual wounds on their trunk or extremities.


1. Li A. Treatment for Burns. 2nd ed. Beijing: People’s Medical Publishing House. 1995;7–14.
2. Dyson M, Franks C, Suckling J. Stimulation of healing of varicose ulcers by ultrasound. Ultrasonics. 1976;14:232–236.
3. Nichter LS, Williams J. Ultrasonic wound debridement. J Hand Surg Am. 1988;13(1):142–146.
4. Byl NN, McKenzie A, Wong T, West J, Hunt TK. Incisional wound healing: a controlled study of low and high dose ultrasound. J Orthop Sports Phys Ther. 1993;18(5):619–628.
5. Suchkova V, Carstensen EL, Francis CW. Ultrasound enhancement of fibrinolysis at frequencies of 27 to 100 kHz. Ultrasound Med Biol. 2002;28(3):377–382.
6. Peschen M, Weichenthal M, Schöpf E, Vanscheidt W. Low-frequency ultrasound treatment of chronic venous leg ulcers in an outpatient therapy. Acta Derm Venereol. 1997;77(4):311–314.
7. Yuesheng H. The clinical courses of burns. In: Li A, ed. Treatment for Burns. 2nd ed. Beijing: The People’s Health Press; 1995:81.
8. Wood RW, Loomis AL. The physical and biological effects of high frequency sound waves of great intensity. Philos Mag J. 1927;4:417–436.
9. Bergstrom N, Allman RM, Alvarez OM, et al. Clinical Practice Guideline Number 15: Treatment of Pressure Ulcers. Rockville, MD: US Department of Health and Human Services. Public Health Service. Agency for Health Care Policy and Research; 1994. AHCPR Publication 95-0652.
10. Mortimer AJ, Dyson M. The effect of therapeutic ultrasound on calcium uptake in fibroblasts. Ultrasound Med Biol. 1988;14(6):499–506.
11. Schoenbach SF, Song IC. Ultrasonic debridement: a new approach in the treatment of burn wounds. Plast Reconstr Surg. 1980;66(1):34–37.
12. Walmsley AD. Potential hazards of the dental ultrasonic descaler. Ultrasound Med Biol. 1988;14(1):15–20.
13. Fyfe MC, Chahl LA. Mast cell degranulation and increased vascular permeability induced by 'therapeutic' ultrasound in the rat ankle joint. Br J Exp Pathol. 1984;65(6):671–676.
14. Byl NN, McKenzie AL, West JM, Whitney JD, Hunt TK, Scheuenstuhl HA. Low-dose ultrasound effects on wound healing: a controlled study with Yucatan pigs. Arch Phys Med. Rehabil. 1992;73(7):656–664.
15. Young SR, Dyson M. The effect of therapeutic ultrasound on angiogenesis. Ultrasound Med Biol. 1990;16(3):261–269.
16. Mortimer AJ, Dyson M. The effect of therapeutic ultrasound on calcium uptake in fibroblasts. Ultrasound Med Biol. 1988;14(6):499–506.
17. Brossman E, Giernat L, Slusarczyl-Zalobna A, Torzecki Z. Histological effects on collagen production in late vitro growth phase of human fibroblasts. Rheumatologica. 1981;19:177–181.
18. Enwemeka CS. The effects of therapeutic ultrasound on tendon healing. A biomechanical study. Am J Phys Med Rehabil. 1989;68(6):283–287.
19. Chen Z, Lai X, Wang L, et al. Experimental study on effect of bacterial clearance and accelerating healing of contaminated wound by low intensity ultrasonic wave irrigation. Acta Acad Med Milit Tertiae. 2001;23(5):617–619.
20. Zhao H, Lai X, Chen J, et al. Design and development of a medical ultrasonic irrigative and therapeutic apparatus. Chin Med Equip J. 2004;9:20–21.

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