by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS
Ultrasound was successfully used as a non-invasive diagnostic tool for years before its potential benefits in wound healing were first investigated. Ultrasound waves, formed when electrical energy is converted to sound waves at frequencies above the range of human hearing, are now routinely used in wound management, and can be transferred to tissue through a treatment applicator. The depth of penetration is dependent on the frequency, with higher frequencies resulting in lower tissue penetration.
Both the thermal and non-thermal properties of ultrasound contribute to its therapeutic benefits. The warmth generated at relatively high intensities can be used in musculoskeletal conditions such as spasm, as well as in the remodeling phase of wound healing to improve scar/wound outcome. The non-thermal effects of ultrasound generated at lower intensities are currently attracting considerable interest, as they appear to cause changes in cell membrane permeability and thus the diffusion of cellular metabolites.
Ultrasound therapy is indicated for chronic or recalcitrant wounds that are clean or infected, pressure wounds, venous insufficiency, acute trauma, and recent surgery. The technique should not be used in simple wounds or in cases of osteomyelitis, bleeding, severe arterial insufficiency, or acute deep vein thrombosis.
Although ultrasound therapy appears to have a number of advantages, the main evidence to support its use still comes from laboratory results, with clinical data proving somewhat disappointing. However, anecdotal reports do provide some evidence for its use in a broad range of wound types.
1. Hess CL, Howard MA, Attinger CE. A review of mechanical adjuncts in wound healing: hydrotherapy, ultrasound, negative pressure therapy, hyperbaric oxygen, and electrostimulation. Ann Plast Surg. 2003 Aug;51(2):210-8.
2. McCulloch J. Physical modalities in wound management: ultrasound, Vasopneumatic devices and hydrotherapy. Ostomy Wound Manage 1995; 41:32-37.
3. Davis SC, Ovington LG. Electrical stimulation and ultrasound in wound healing. Derm Clinics 1993;11(4):775-781.
4. Dyson M. Therapeutic application of ultrasound. Clin Diagnost Ultrasound 1985;16:121-134
About The Author
Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS is a Certified Wound Therapist and enterostomal therapist, founder and president of WoundEducators.com, and advocate of incorporating digital and computer technology into the field of wound care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.