Polak A, Franek A, Blaszczak E, Nawrat-Szoltysik A, Taradaj J, Wiercigroch L, Dolibog P, Stania M, Juras G, et al.
Ostomy/wound management. Date of publication 2014 Aug 1;volume 60(8):16-28.
1. Ostomy Wound Manage. 2014 Aug;60(8):16-28.
A prospective, randomized, controlled, clinical study to evaluate the efficacy of
high-frequency ultrasound in the treatment of Stage II and Stage III pressure
ulcers in geriatric patients.
Polak A(1), Franek A(2), Blaszczak E(2), Nawrat-Szoltysik A(3), Taradaj J(4),
Wiercigroch L(2), Dolibog P(2), Stania M(3), Juras G(3).
Author information:
(1)Academy of Physical Education, Katowice, Silesia; email:
a.polak@awf.katowice.pl; polanna@op.pl.
(2)Medical University of Silesia, Katowice, Poland.
(3)Academy of Physical Education, Katowice, Silesia.
(4)Academy of Physical Education, Katowice, Silesia; and Institute of Physical
Therapy, Public School of Medicine, Opole, Poland.
International guidelines recommend high-frequency ultrasound (HFUS; MHz) for
treating infected pressure ulcers (PUs). A 2-year, prospective, randomized,
controlled study was conducted to evaluate how HFUS affects PU healing among 42
geriatric patients treated in four nursing and care centers in Silesia, Poland.
Participants (age range 71-95 years,) all with wounds that did not respond to
previous treatment for at least 4 weeks, were randomly assigned to the treatment
group (TG) (20 with 21 PUs, mean age 83.60 ± 5.04 years) or control group (CG)
(22 with 23 PUs, mean age 82.59 ± 6.65 years). All patients received standard
wound care (SWC); the TG additionally was provided HFUS (1 MHz, 0.5 W/ cm2, duty
cycle of 20%, 1-3 minutes/cm2; one session per day, 5 days a week). Patients were
monitored for 6 weeks or until wounds closed. Percent change in wound surface
area (WSA), the Gilman's parameter, the weekly rate of change in WSA, and the
percentage of PUs that improved (ie, decreased in size by at least 50% or closed)
were used to compare differences. Data were analyzed using Fisher's exact test,
the Wilcoxon matched pairs test, and the Mann-Whitney U test (P <0.05). Mean
baseline WSA and the pretreatment duration of PUs were 15.38 ± 12.92 cm2 and 1.64
± 0.73 months and 11.08 ± 7.52 cm2 and 2.26 ± 1.42 months in the TG and CG
groups, respectively. After 6 weeks of treatment, the WSA of PUs decreased
significantly in both groups (P = 0.000069 in the TG and P = 0.0062 in the CG)
with significantly greater improvement in the TG (an average of 68.80% ± 37.23%
compared with 37.24% ± 57.84%; P = 0.047). The value of the Gilman's parameter
was greater in the TG than in the CG (0.88 ± 0.62 and 0.43 ± 0.50, respectively;
P = 0.018). The mean weekly change of WSA was greater in the TG than in the CG
but only for Stage II PUs (3.09 ± 2.93 cm2/week and 1.08 ± 1.43 cm2/week; P =
0.045). More Stage II PUs in the TG decreased by at least 50% (11 of 14 = 78.57%)
than in the CG (seven of 18 = 38.89%) (P = 0.035). In the TG, seven of 14 (50%)
Stage II PUs closed, four of seven (42.86%) Stage III PUs decreased by at least
50%, and one of seven (14.29%) Stage III PUs closed; respective values for the CG
are three of 18 (16.67%), three of five (60%,) and zero of five (0%) (P = 0.062,
P = 0.999, P = 0.999, respectively). The study showed HFUS therapy can reduce the
WSA of PUs regardless of their shape, but further research is necessary,
particularly to establish how ultrasound influences the healing of Stage III and
Stage IV PUs.
PMID: 25105475 [Indexed for MEDLINE]
