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

10/14/2009
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Author(s):

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

Wound swab cultures were collected at baseline (prior to initial application of either the ultrasound or control wound dressing change at the initial visit) and after the fourth visit, respectively. All cultures were collected as follows: 1) A rayon-tipped swab applicator was rotated in a zig-zag pattern on the wound surface; 2) the tip of the swab was then inserted into a sterile round bottom polypropylene tube containing a non-nutritive, highly conductive transport medium; 3) all culture samples were sent immediately to the laboratory for bacterial colony count analysis. Then the log colony forming unit counts (CFU/mL), based on wound area (cm2), was calculated as CFU/mL/cm2. The wound bacterial clearance rate was calculated as follows (Graph 2):

Systemic reaction and local acrimony in skin and other side effects were observed in the process of the experiment. Routine testing of blood, urine, and secretions, liver and kidney function tests, and electrocardiogram tests were performed before and after the treatment period.

Efficacy assessment standards. Two doctors inspected each wound and determined its healing status. Assessment and comments on each patient’s information and the treatment efficacy were recorded.

Healing time/percentage. The healing time of the wound was calculated as the number of days to achieve 100% wound healing. The healing percentage of the wound was recorded if the wound had not completely healed when the treatment period expired.

Clinical efficacy. Four levels of clinical efficacy were assessed and recorded after the study: healed, obviously effective, effective, and ineffective. Both the healed and obviously effective levels were considered effective, and percentages were calculated. The criteria for the 4 levels of effectiveness were:

• Healed: area where therapy was applied has completely healed
• Obviously effective: 50% of the wound is healed; no inflammation
• Effective: more than 20% of the wound is healed; less reddish and exudative
• Ineffective: the wound infection is not under control and the effective standard has not been met.

Safety assessment. Systemic reaction, side effects, abnormal indices, and skin irritation were assessed and determined according to the 5 levels: clearly relevant, probably relevant, probably irrelevant, clearly irrelevant, and unable to determine. The degree and incidence of side effects were described.

Statistical Analysis

Chi-squared analysis was used to compare the ordinal and categorical data, and the t-test was used to compare the average of continuous data. Statistical software (SPSS) was used to analyze data.

Results

Nineteen eligible patients (2 women, 17 men) were carefully observed. All patients served as self-control. The patients ranged in age 30 to 56 years (average age 44.9). The burn wounds had existed from 71 days to 256 days after injury. The average wound duration was 94.6 days after injury.

Residual wound healing rate. The total healing rate of the residual wounds in the treatment group was significantly greater than that in the control group, on average 2.38 times greater (P < 0.01). This was especially obvious in the mild and moderate infectious subgroups when the study ended (Table 1).

Treatment efficacy rate.

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