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