Application of various power densities of ultrasound in the treatment of leg ulcers

Abstract

We have demonstrated that ultrasound rated at 0.5 W/cm(2) causes greater and faster changes in the healing process than ultrasound rated at 1 W/cm(2).

Evidenced-Based Management of a Chronic Wound in an Elderly Female Patient with Type II Diabetes

“…15 Support was found for an ultrasound frequency of 1 or 3 MHz. 18,22,[25][26][27] In the present case, the superficial location of the ulcer supported a decision to use 3 MHz ultrasound (based on a half-depth penetration of 3 MHz ultrasound in soft tissue of approximately 1.6 cm).…”

“…A 2008 Cochrane update 15 included the seven prior RCTs plus one new study that used traditional ultrasound applied in contact via gel coupling. 18 Pooling trials for the outcome of relative risk of healing showed that more ulcers were healed using ultrasound (risk ratio ¼ 1.49, 95% CI: 1.07-2.09). For trials reporting the percentage of ulcer area remaining, pooled results showed that ultrasound was beneficial (weighted mean difference ¼ À5.34%, 95% CI: À8.38 -À2.30).…”

“…Ultrasound intensity at 0.5 W/cm 2 or 1.0 W/cm 2 , spatial average-temporal peak (SATP), delivered in pulsed mode using a 1:4 ratio, consistently produced favourable results in the individual trials. 18,22,[25][26][27] Treatment of 1.0 W/cm 2 , SATP, 1:4 ratio, was favoured in this case, based on personal experience treating similar wounds, with a plan to re-evaluate intensity if there was no evidence of improvement after three treatments.…”

“…Treatment duration of 15 minutes was selected based on the original work of Dyson, 26 later replicated by others, 18,27 using 5 minutes of ultrasound for ulcers less than 2.5 cm 2 (the size of a dime) with an increase of 1 minute for each extra 0.5 cm 2 of ulcer area. Callam, 25 and more recently Taradaj, 22 used similar protocols.…”

Clinician's Commentary on Armijo-Olivo et al.

“…Delivered in pulsed mode, US is used to facilitate cellular processes, enhance the resolution of inflammation, [3][4][5][6] and facilitate wound healing. 7,8 A recently published study showed that pulsed US increased cartilage thickness in people with knee osteoarthritis; 9 in other studies, therapeutic US has been shown to increase fracture healing rates when delivered at low intensity in pulsed mode. 10-12 US has also been used to enhance drug delivery into tissues.…”