Sound Evidence - November 2008 - (Page 56) Sound Evidence Acoustic Pressure Wound Therapy in the Treatment of Stage II Pressure Ulcers Raenell Thomas, RN, RAC-C Cherry Creek Nursing Center Aurora, Colorado Pressure ulcers are localized skin injuries secondary to unrelieved pressure or friction. Patients with immobility issues are at increased risk for developing pressure ulcers. In 2004, stricter federal regulations for prevention and treatment of pressure ulcers in institutional settings — eg, long-term care facilities — were introduced. Effective, low-cost treatments for pressure ulcers are needed; acoustic pressure wound therapy (APWT), a noncontact, low-frequency, therapeutic ultrasound system, is one option. A retrospective case series of six long-term care patients (two men and one woman, age range 61 to 92 years), each with one Stage II pressure ulcer, is presented. Acoustic pressure wound therapy was provided as an adjunct to standard treatment that included balsam of Peru/castor oil/trypsin ointment, hydrogel, hydrocolloid dressings, silver dressings, and offloading. Outcomes (days to healing) were determined through changes in wound dimensions. Study participants each received APWT for 3 to 4 minutes three to four times weekly. In four of the six wounds, the average number of days to healing was 22. One of the two remaining patients discontinued treatment at 95% healed; treatment for the sixth patient was ongoing due to hospitalization that delayed APWT. In a long-term care setting, APWT added to standard of care may accelerate healing of Stage II pressure ulcers. KEYWORDS: acoustic pressure wound therapy; pressure ulcer; wounds Ostomy Wound Management 2008;54(11):56–58 ressure ulcers (PU) are localized skin injuries, typically over a bony prominence, that develop as the result of unrelieved pressure, friction, or shear. They range from intact reddened skin (Stage I) to exposed bone (Stage IV).1 Pressure ulcers can become chronic, debilitating, painful, and life-threatening. They are a common problem in patients with reduced mobility.2,3 Patients in long-term care (LTC) facilities are at an increased risk of developing PUs. In the nursing home setting, the median time to heal a P Stage II PU has been found to be 46 days.4 In 2004, stricter federal guidelines for the prevention and treatment of PUs in LTC facilities were instituted,2 increasing the economic burden of PUs in this setting. Acoustic pressure wound therapy (APWT; MIST® Therapy System; Celleration, Eden Prairie, Minn) is a noncontact, low-frequency, nonthermal ultrasound therapy delivered via sterile, saline mist. The acoustic energy stimulates wound healing at the cellular level5 and cleanses and debrides wounds. A growing body of 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. 56 OstomyWound Management http://www.celleration.com
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