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Background: High-frequency ultrasound may be better than visual inspection and palpation for identifying and evaluating damage to soft tissue of pressure ulcers1-3). Researchers believe that it is important to examine the periwound of soft tissue for assessment of prognosis of pressure ulcer. However, no reports have described the periwound area of pressure ulcers.
Purposes: Purpose of the study was to clarify the ultrasonographic findings of the periwound area of pressure ulcers in a prospective analysis.
Methods: Four patients with pressure ulcers without undermining formation were included. We observed the progress of pressure ulcers and examined the periwound area ultrasonographically (12 MHz) every 2 weeks. This study was approved by the ethical review board of Kanazawa University medical department.
Results: Ultrasonography revealed tissue damage in all pressure ulsers. Ultrasonographic images were either heterogeneously hypoechoic (HE type, 2 patients), signs of inflammatory oedema, or resembled stone paving (SP type, 2 patients). In 1 HE patient, undermining appeared after 2 weeks and the area of undermining increased after 4 weeks. In the other patient, the HE area disappeared after 2 weeks and healed after 4 weeks. Conversely, both SP patients developed undermining. In one patient, the SP area increased after 2 weeks, undermining developed at 4 weeks. In the other SP patient, the SP area increased from 2 to 8 weeks and considerable undermining was observed at 10 weeks.
Conclusion: Two characteristic ultrasonographic features of periwound tissues of pressure ulcers were found, namely HE and SP. HE showed inflammatory oedema which resolved. Thus, identification of HE areas and avoidance of pressure and shear force in these areas should lead to wound healing. SP lesions supposed to be fat necrosis and irreversible changes. Therefore, we suggest that debridement is required to promote wound healing.
Purposes: Purpose of the study was to clarify the ultrasonographic findings of the periwound area of pressure ulcers in a prospective analysis.
Methods: Four patients with pressure ulcers without undermining formation were included. We observed the progress of pressure ulcers and examined the periwound area ultrasonographically (12 MHz) every 2 weeks. This study was approved by the ethical review board of Kanazawa University medical department.
Results: Ultrasonography revealed tissue damage in all pressure ulsers. Ultrasonographic images were either heterogeneously hypoechoic (HE type, 2 patients), signs of inflammatory oedema, or resembled stone paving (SP type, 2 patients). In 1 HE patient, undermining appeared after 2 weeks and the area of undermining increased after 4 weeks. In the other patient, the HE area disappeared after 2 weeks and healed after 4 weeks. Conversely, both SP patients developed undermining. In one patient, the SP area increased after 2 weeks, undermining developed at 4 weeks. In the other SP patient, the SP area increased from 2 to 8 weeks and considerable undermining was observed at 10 weeks.
Conclusion: Two characteristic ultrasonographic features of periwound tissues of pressure ulcers were found, namely HE and SP. HE showed inflammatory oedema which resolved. Thus, identification of HE areas and avoidance of pressure and shear force in these areas should lead to wound healing. SP lesions supposed to be fat necrosis and irreversible changes. Therefore, we suggest that debridement is required to promote wound healing.