Background/Purpose: A large portion of the patients seen in wound care clinics are being treated for lower extremity ulcers. Ulcers are often caused by pathologies affecting the circulation, such as diabetes mellitus. Patients who are prone to these ulcers often face a lengthy and repetitive healing cycle as normal' tissue repair is hindered by venous or arterial dysfunction. Effective and timely healing of these ulcers is not only a matter of improving quality of life, but can be the determinate of amputation versus limb salvage in severe cases. The purpose of this analysis is to determine if ultrasound therapy is an effective intervention to reduce healing times and facilitate wound closure in these difficult to heal cases. Case Description: Patient is a 51 year old obese white male referred to outpatient physical therapy wound care for bilateral lower extremity ulcers and edema secondary to venous insufficiency. He presents with two small wounds on right lower extremity and one small wound on left lower extremity. Patient has had ulcer formation in the past several years and has historically been non-compliant with consistent application of compression stockings to prevent exacerbation of symptoms. Patient's vascular insufficiency resulting in edema, in combination with lifestyle factors such as tobacco use and low activity status, will slow progression of wound healing. Compliance in application of compression garments, tobacco cessation, and activity levels will contribute to patient's long term potential in healing and prevention of future skin breakdowns. Outcomes and Discussion: The wound care team was able to facilitate healing through secondary intention, however the duration of healing was approximately 12 weeks. This patient would have been a prime candidate for ultrasound therapy to expedite healing processes. When evaluated individually, the evidence of the efficacy of ultrasound as a wound healing modality is lacking. However, the number of articles supporting its efficacy warrants, at the least, further investigation. 3 No serious or life threatening adverse reports were noted in any of the reports surveyed and although initial costs could be significant, the benefit of ultrasound therapy in reducing healing times likely would reduce overall expenditure on extensive wound care treatment of chronic wound care patients according to the seven of eight articles analyzed for this review.
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ultrasound, wound, ulcer
Leazer, Anne. "Ultrasound Therapy and Wound Care; Literature Analysis and Case Presentation." (2014). https://digitalrepository.unm.edu/dpt/80
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