A Pilot Study of Ultrasonically-assisted Treatment of Residual Burn Wounds
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These effects change cell membrane permeability and increases cellular metabolite diffusion.2,10 The mechanical energy of ultrasound has been applied to debride and cleanse wounds.11,12 Additionally, other ultrasound effects including promotion of histamine release,13 mast cell degranulation,13,14 angiogenesis,15 increases in intracellular calcium,16 increases in collagen deposition and wound-breaking (or tensile) strength,4,17,18 and wound size reduction14 have been demonstrated.
This pilot study intended to assess the acceptability and tolerability of a novel form of ultrasonic treatment (UWI-Haiwei ultrasonic debridement machine) on patients whose sloughy, fibrotic, residual burn wounds had failed to respond to traditional treatment regimens. The ultrasound frequency (40 kHz) was used in the present study based on its efficient use in experiments on rats.19 The ultrasound frequency and length of the therapeutic sessions were varied and dependent on the severity of infection and size of the individual wound.20 Each patient served as his or her own control. This study demonstrated that residual wounds of the treatment group improved dramatically within 2 weeks, and that the healing rate was significantly higher than that of the control group. An interesting observation from the study was that improvement in healing continued after the treatment and that complete healing might be gained by continuing treatment.
Some studies doubt that the mechanical force applied to the wounds may “drive” the microbes deeper into the tissue creating a wound with bacterial colonization into one with a spreading infection—this particular phenomenon was not observed in the present study. Conversely, all wounds treated with ultrasound reduced odor and local signs of cellulitis. The bacterial colony counts in the treatment group decreased significantly after 4 treatments with the ultrasonic debridement machine, whereas the control group showed a slight difference of the bioburden between the baseline and the fourth treatment. The clearance of the bacteria of ultrasonic wounds was significantly higher than that of the control wounds.
No definite systemic or local side effects were observed in this study.
This study shows that treatment with an ultrasonic debridement machine effectively improves the healing process of residual burn wounds, restrains the growth of bacteria in wounds, which may reduce the frequency of dressing changes, and does not cause much pain.
This work was supported by a grant from the National Natural Science Foundation of China (No. 30600648).
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