Use of ultrasound in assessment of necrotic tissue in pressure ulcers with adjacent undermining

Abstract

The authors have no conflicts of interest to declare. There were no external sources of funding for this study.

Do High Frequency Ultrasound Images Support Clinical Skin Assessment?

“…Increasing attention is being paid to the use of high frequency ultrasound scanning as a modality for wound and ulcer examination [9, 11] with some reports highlighting the potential application of high frequency ultrasound in imaging suspected subcutaneous oedema pertaining to pressure ulcers [7, 8, 10]. That is, in providing images of tissue damage below the skin surface that cannot be seen by the naked eye.…”

“…A number of techniques capable of early detection have been proposed, including the ultrasonic visualisation of subcutaneous oedema [4, 7, 8]. High frequency ultrasound (HFUS), at a frequency of 20 MHz, allows the real-time two-dimensional imaging of internal structures in a noninvasive manner and has been shown to be a potentially valuable method for the assessment of subcutaneous tissue damage pertaining to numerous pathophysiologies including the evaluation of wounds [7, 9–11]. The potential it offers in establishing parameters associated with the echogenicity of the ultrasound image could provide earlier identification of tissue damage than that being achievable through clinical skin assessment or photography alone [7, 8].…”

Three-dimensional ultrasound imaging of the pressure ulcer. A case report

“…2D-US can be used to estimate tissue damage in localized sites of inflammation and will reveal whether a PU is cystic, solid, or mixed [5,7].Another application of 2D-US is in monitoring the tumor size, the extension into adjacent structures, and evidence of PU. However, 2D-US does not provide multiple continuous images in multi-directional planes.…”

“…Previous reports suggested the use of two-dimensional ultrasound (2D-US) to assess the pathogenesis of PUs [4][5][6][7][8], based on its ability to produce high-quality images of superficial tissue and its safety and utility in daily practice. However, 2D-US does not completely depict a PU in a single image.…”

“…However, 2D-US does not completely depict a PU in a single image. With three-dimensional ultrasound (3D-US) PUs can be imaged in their entirety such that the images can be used as a prognostic indicator [7] and communicated to other, relevant caretakers (health professionals, parents).…”