Institutional Affiliation: Seton Specialty Hospital, Indianapolis, Indiana (formerly Carmel Seton Specialty Hospital)

Purpose: Cardiovascular and peripheral vascular diseases contribute to wound chronicity. This case report describes the course and outcomes of noncontact, low-frequency, ultrasound therapy* to expedite healing of a dehisced surgical incision.

Case Descriptions: A 76-year-old Caucasian man presented to our unit 38 days status post surgical repair of an ascending aortic aneurysm. The sternal incision had separated. His comorbidities included hypertension, coronary artery disease, venous insufficiency, and history of cerebrovascular accident. He was ventilator-dependent and used a manually operated wheelchair. Initial treatment consisted of papain-urea with chlorophyllin copper complex ointment and gauze dressing. After 10 days of this treatment, noncontact, low-frequency ultrasound was administered as an adjuvant therapy 3 times per week for 3 minutes per session.  

Outcomes: At the start of noncontact ultrasound therapy on March 7, 2007, wound volume was 12.60 cm³ and wound area was 4.20 cm². After 4 weeks of thrice weekly ultrasound in addition to papain-urea/chlorophyllin copper complex dressing, the wound closed completely. As shown in the figure, wound volume began to decline during the first week of noncontact ultrasound therapy and entered a steep decline during the second and third weeks. Lack of wound depth by the end of Week 3 resulted in absence of wound volume at that visit. Wound area increased very slightly during the first week of treatment but entered a steep decline during the second and third weeks resulting in complete wound closure by the end of Week 4.

Discussion: This patient's poor vascular and pulmonary health is typically associated with delayed wound healing such that complete closure could be expected to take 8-12 weeks. Complete healing of this dehisced surgical wound with 4 weeks of noncontact, low-frequency ultrasound therapy compares favorably to the expected rate of healing.

* MIST Therapy System, Celleration, Inc., Eden Prairie, Minnesota