Sound Evidence - March 2008 - (Page 56) Sound Evidence Acoustic Pressure Wound Therapy for Management of Mixed Partial- and Full-Thickness Burns in a Rural Wound Center John Samies, MD; and Marie Gehling, RN, BSN, CWOCN The Regional Medical Center of Orangeburg and Calhoun Counties, Orangeburg, SC Infection, pain, and cosmetically unacceptable scarring frequently complicate full-thickness burns. Outpatient management can be difficult without specialized care. A retrospective case series study was conducted in a rural wound center lacking specialized burn care to assess the clinical effectiveness of acoustic pressure wound therapy, a noncontact low-frequency, nonthermal ultrasound wound therapy that accelerates healing through positive pressure, stimulating fibroblasts, clearing bacteria and debris, and relieving pain. Data from the records of 14 consecutively treated outpatients (age range 5 months to 78 years old) with mixed partial- and full-thickness burns involving the trunk, extremities, or both, averaging 7% of body surface area (range: 1% to 24%), were reviewed. Patients received acoustic pressure wound therapy with standard burn care. Burn thickness was determined by clinical appearance. Treatment effectiveness was evaluated based on scarring characteristics of healed wounds (ie, cosmetic appearance) and pain resolution. Pain was patient-rated using a 10-point visual analog scale (0 = no pain, 10 = severe). Patients were followed for 6 months post-healing. Pain improved with therapy (range: two to 10 treatments). No patient required hospitalization or developed complications related to infection. Pliable, nonhypertrophic scars developed in 86% of patients and hypertrophic scars developed in 14%. Repigmentation was seen in 79% of patients, with only minor irregularities; hypopigmentation occurred in 21%. Scars available for follow-up (71%) remained unchanged. Acoustic pressure wound therapy with standard burn care was found to heal mixed partial- and full-thickness burns and reduced pain in outpatients, resulting in cosmetically acceptable scarring without infectious complications, surgery, or skin grafts and may prove beneficial for inpatient management of extensive full-thickness burns. Further study is warranted. KEYWORDS: acoustic pressure wound therapy, debridement, noncontact ultrasound, outpatient burn care, wounds Ostomy Wound Management 2008;54(3):56–59 ore than one million burn injuries occur in the US annually, resulting in more than 500,000 emergency department visits and 40,000 hospitalizations.1 While most burns can be treated on an outpatient basis,2 treatment can be difficult without specialized care.3,4 M Burns are classified by depth of tissue damage. Partial-thickness burns can extend to the dermis and are usually extremely painful. Healing can occur within 10 to 14 days, depending on wound size.5 Fullthickness burns extend to the subcutaneous layer and are typically painless due to nerve destruction. Support for Sound Evidence is provided by an educational grant from Celleration, Inc. to HMP Communications/Ostomy Wound Management. The opinions and statements herein, as well as the selection of metrics to measure wound healing, are specific to the authors and are not necessarily those of Celleration, Inc., OWM, or HMP Communications, LLC. Please note: these articles are subject to peer review. The opinions herein may not be consistent with the labeling for MIST Therapy System. Patients are selected for your educational benefit. View celleration.com for the full package insert. Results may vary. 56 OstomyWound Management http://celleration.com
Table of Contents Feed for the Digital Edition of Sound Evidence - March 2008 Sound Evidence - March 2008 Acoustic Pressure Would Therapy for Management of Mixed Partial- and Full-Thickness Burns in a Rural Wound Center Sound Evidence - March 2008 Sound Evidence - March 2008 - Acoustic Pressure Would Therapy for Management of Mixed Partial- and Full-Thickness Burns in a Rural Wound Center (Page 56) Sound Evidence - March 2008 - Acoustic Pressure Would Therapy for Management of Mixed Partial- and Full-Thickness Burns in a Rural Wound Center (Page 57) Sound Evidence - March 2008 - Acoustic Pressure Would Therapy for Management of Mixed Partial- and Full-Thickness Burns in a Rural Wound Center (Page 58) Sound Evidence - March 2008 - Acoustic Pressure Would Therapy for Management of Mixed Partial- and Full-Thickness Burns in a Rural Wound Center (Page 59)
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