Sound Evidence - March 2008 - (Page 58) grafts typical for serious and extensive burns.2 Based on the results of this limited case series, studies of APWT as an adjunct to standard therapies for inpatient burn management are warranted. Acknowledgment Tracey Fine, MS, ELS, assisted with manuscript preparation. - OWM References 1. American Burn Association. Burn Incidence and Treatment in the US: 2007 Fact Sheet. Chicago: American Burn Association;2007. Available at www.ameriburn.org/resources_factsheet.php. Accessed February 22, 2008. Edlich RF, Drake DB, Long WB. Burns, thermal. eMedicine 2007. Available at www.emedicine.com/plastic/topic518.htm. Accessed January 3, 2008. Sagraves SG, Phade SV, Spain T. A collaborative systems approach to rural burn care. J Burn Care Res. 2007;28(1):111–114. Moss L. Outpatient management of the burn patient. Crit Care Nurs Clin N Am. 2004;16(1):109–117. McCain D, Sutherland S. Nursing essentials: skin grafts for patient with burns. Am J Nurs. 1998;98(7):34–39. Myers B. Wound Management Principles and Practice. 1st ed. Upper Saddle River, NJ: Prentice Hall Co;2004. Lai JY, Pittelkow MR. Physiological effect of ultrasound mist on fibroblasts. Int J Dermatol. 2007;46(6):587–593. Houghton PE, Thawer HA. Effects of ultrasound delivered through a mist of saline to wounds in mice with diabetes mellitus. J Wound Care. 2004;13(5):1–6. Wagner SA, Kavros SJ, Vetter EA, Cockerill FR. The effect of MIST ultra-sound transport technology on common bacterial wound pathogens. Presented at 14th annual Symposium on Advanced Wound Care, Las Vegas, Nevada. May 2, 2001. Mohr P, Stegmann W, Breitbart EW. Low-frequency ultrasound treatment of chronic venous ulcers. Wound Repair Regen. 1997;5:18–22. Ennis WJ, Vadles W, Gainer M, Meneses P. Evaluation of clinical effectiveness of MIST ultrasound therapy for the treatment for the healing of chronic wounds. Adv Skin Wound Care. 2006;19:437–446. Ennis WJ, Formann P, Mozen N, et al. Ultrasound therapy for recalcitrant diabetic foot ulcers: results of a randomized, double-blind, controlled, multicenter study. Ostomy Wound Manage. 2005;51(8):24–39. Kavros SJ, Miller JL, Hanna SW. Treatment of ischemic wounds with noncontact, low-frequency ultrasound: the Mayo clinic experience, 2004–2006. Adv Skin Wound Care. 2007;20(4):221–226. Haan J, Lucich S. MIST Therapy® System — thoughts on therapy: case series #2. ECPN. 2007;116(2):39–43. Gehling ML, Samies JH. The effect of noncontact, lowintensity, low-frequency therapeutic ultrasound on lowerextremity chronic wound pain: a retrospective chart review. Ostomy Wound Manage. 2007;53(3):44–50 Figure 1c. Patient 14 at treatment completion — 3.5 weeks. 2. Topical treatments included antimicrobials (eg, silver sulfadiazine 1% and hydrofiber with silver) and petroleum gauze dressings; one patient received enzymatic debridement and whirlpool treatments (pre-APWT). Pain resolved within one and 10 APWT treatments. No hospitalizations or burn infections occurred. Pliable, nonhypertrophic (ie, flat) scars developed in 86% of patients (see Figure 1a–c). Repigmentation developed in 79% of patients, with cosmetically acceptable appearance in 71%. All burns healed between 1 week and 45 weeks. Follow-up data were available for 71% of patients; nine at 6 months and one at 3.5 months (this patient died of unrelated causes before the 6month follow-up). Initial scar assessments (see Table 1) were unchanged at follow-up. Four patients were lost to follow-up. 3. 4. 5. 6. 7. 8. 9. 10. 11. Conclusion The effectiveness of APWT in outpatient care for mixed partial- and full-thickness burns was demonstrated in 14 patients through cosmetically acceptable scarring (ie, predominantly pliable, nonhypertrophic scars and repigmentation) and pain reduction. No patient developed infectious complications. Initial scar assessments were maintained through follow-up. As this was not intended as a comparative trial, no comparison to treatment without APWT is possible nor is literature available as a historic control in a similar population. The mixed partial- and full-thickness burns in this retrospective study healed without surgery or skin 12. 13. 14. 15. 58 OstomyWound Management http://www.ameriburn.org/resources_factsheet.php http://www.emedicine.com/plastic/topic518.htm
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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