Introduction: Debridement is critical for promoting healing of chronic wounds. Although the effectiveness of ultrasound debridement in wounds with biofilms is known, its clinical indications and limitations remain unclear. We report the results, indications, and limitations of the use of a new ultrasound debridement device for treating chronic wounds. Materials and methods: The study included five patients with wounds (a total of seven wounds) covered by biofilms that were treated with ultrasound debridement from April to July 2021. To evaluate the efficacy of debridement, pre-and post-debridement photographs were compared and evaluated by three surgeons. The panel was ranked according to two criteria based on unhealthy granulation, necrotic tissue, and gel-like substance/film using a 5-point scoring system, with a maximum score of 10. A score of > 7 after debridement was considered successful debridement. The numeric and faces pain rating scales were used to evaluate pain. Results: Four of the seven wounds were judged to have been successfully debrided. In wounds with a high percentage of hard necrotic tissues, debridement tended to be ineffective. The average debridement score was 5.7 for all patients and 9.2 for those without hard necrotic tissues. The gel-like substance was completely removed in all cases. Pain was mild, ranging from 1 to 3 on the numerical rating scale and from 1 to 2 on the faces pain rating scale. The bleeding amount was lesser with ultrasound debridement than with debridement using a sharp curette. Conclusions: Ultrasound debridement is effective in reducing pain and removing biofilms with minimal bleeding. Its main applications include the removal of morbid granulation and soft necrotic tissues and gel-like substances. Ultrasound debridement is a good indication for use in conjunction with surgical or hydraulic debridement to facilitate the removal of hard necrotic tissues.

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Spindle cell lipoma (SCL) is a subtype of lipoma first defined by Enzinger; it accounts for ~1.5% of all fatty tumors. Most cases occur in the posterior neck and shoulders of middle-aged men and rarely in women or the occiput. A 41-year-old woman presented to us with complaints of a mass on her left occiput which had slowly grown in size over six years. We excised the tumor, and pathological findings confirmed the diagnosis of SCL. There was no recurrence one year after the surgery.