SoundEvidence - June 2008 - (Page 67) A. March 26, 2007 B. April 4, 2007 Figure 1a,b. Calf with partial- to full-thickness thermal burns before (A) and after (B) noncontact ultrasound treatment. exacerbates wound-related pain; therefore, attention to pain and anxiety is essential.5 The MIST® Therapy System (Celleration, Eden Prairie, Minn) is a noncontact, low-frequency, nonthermal ultrasound (LFTU) treatment that promotes wound healing through cleansing and maintenance debridement. The ultrasound waves are delivered via sterile saline mist, making treatments painless. Nonthermal ultrasound has been used to effectively treat acute and chronic wounds, 6-8 including burns.9 This case series reviews the clinical effectiveness of LFTU in six patients with thermal burns. area from 14.9 cm2 to 60.0 cm2; and a superficialpartial-thickness burn, area 19.0 cm 2. Patients received LFTU as an adjunct to conventional burn care (eg, sulfadiazine cream 1% and nonadherent dressings). Treatments were administered one to five times weekly for 3 to 20 minutes, depending on the burn surface area. Results Six patients with a total of seven thermal wounds were treated. Nonthermal ultrasound was used to cleanse and debride wounds; the wounds demonstrated rapid granulation and pain resolved (see Table 1 and Figure 1). Patients reported no pain with removal of fibrin, slough, and eschar. Exudate was reduced to minimal amounts of serous fluid in 1 to 3 weeks. Wound areas decreased an average of 76% in 3 weeks (see Figure 2). All patients reported complete pain reduction. Complete epithelialization was achieved in 1 to 6 weeks. Surgery was not required for wound closure. Methods Consenting outpatients were nonrandomly selected for treatment with LFTU based on wound bed composition (ie, slough and necrosis requiring debridement). The effectiveness of LFTU was evaluated through changes in wound bed composition, size, exudate, and pain. Patients rated pain using a 10-point numerical rating scale, where 0 = no pain and 10 = extreme pain. Treatment continued until wound beds were predominantly granulated. Ultrasound was used as an adjunct to conventional burn care. Discussion The essentials of burn care are debridement and infection control. Managing pain and anxiety are important treatment concerns. As an adjunct to conventional burn care, LFTU was used to cleanse and debride partial- to full-thickness thermal burns. Treatment was painless because the device does not contact the wound. Burn patients are predisposed to infection because necrotic tissue is an excellent culture medium for June 2008 Vol. 54 Issue 6 Case Reports Six patients, 8 to 73 years old, received LFTU. Patients’ wounds included three partial-full-thickness burns, ranging in area from 83.6 cm2 to 375.0 cm2; two deep-partial-thickness burns, ranging in 67
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.