SoundEvidence - August 2008 - (Page 50) Sound Evidence Acoustic Pressure Wound Therapy to Facilitate Granulation Tissue in Sacral Pressure Ulcers in Patients with Compromised Mobility: A Case Series Jo Schmuckler, PT, Kindred Hospital, Havertown, Pa Electrical stimulation and other modalities are recommended for treatment of pressure ulcers in spinal cord injury patients but their use may be limited by clinical contraindications such as necrosis and infection. Acoustic pressure wound therapy can be used to address infection and has no known contraindications related to wound status. A retrospective nonconsecutive study was conducted involving five inpatients with sacral pressure ulcers and compromised mobility (spinal cord injury, ventilator/mobility dependency, or persistent vegetative state) treated with acoustic pressure wound therapy three times per week, 4 to 6 minutes per session, for 5 weeks to 5.5 months. Acoustic pressure wound therapy was administered until necrotic tissue was removed, granulation was complete, drainage resolved to moderate levels, and wound size was compatible with indications for high-voltage electrical stimulation. Within 1 to 4 weeks of starting acoustic pressure wound therapy, four out of five wounds with substantial yellow slough or eschar demonstrated 100% granulation tissue and wound area and volume decreased 71% to 97% and 75% to 99%, respectively. Subsequent treatments included electrical stimulation alone (three patients) or in conjunction with negative pressure wound therapy (one patient), and silver foam (one patient). Acoustic pressure wound therapy was found to be an effective option in preparing wounds for subsequent therapy. Key words: acoustic pressure wound therapy, pressure ulcers, debridement, wound care Ostomy Wound Management 2008;54(8):50–53 ressure ulcers are an ever-present concern for patients with compromised mobility resulting from spinal cord injuries or other conditions that severely restrict mobility. These chronic wounds, which occur in an estimated 1.3 to 3.0 million Americans,1 are associated with fatal septic infections and are reported as a cause of thousands of deaths P each year in the US.2 Incapacitating conditions, such as paralysis and neurodegenerative diseases, increase risk not only of developing a pressure ulcer, but also of pressure ulcer-associated death.2 Current clinical practice guidelines from the Wound Healing Society and the Consortium for Spinal Cord Medicine3 indicate that high-voltage Support for Sound Evidence is provided by an educational grant from Celleration, Inc, Eden Prairie, Minn, to HMP Communications/Ostomy Wound Management. Celleration support to authors included medical writing and/or statistical support only; study design, patient selection, data collection, and metrics to measure wound healing are specific to the author. The opinions and statements herein are also specific to the author and are not necessarily those of Celleration, Inc., OWM, or HMP Communications. Please note: these articles are subject to peer review. The opinions herein may not be consistent with the labeling for MIST Therapy Systems. Patients are selected for educational benefit. Visit www.celleration.com for the full package insert. Results may vary. 50 OstomyWound Management http://www.celleration.com
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