Pulsed Radio Frequency Energy Therapy in Elderly Patients with Pressure Ulcers in Long-Term Care Settings: an Analysis of 224 Wounds

Rationale:           Pressure Ulcers are associated with significant morbidity and mortality, and require extensive nursing care.  Medical technologies which accelerate healing of these challenging wounds can improve quality of life and limit health care costs.  The response of advanced pressure ulcers to Pulsed Radio Frequency Energy (PRFE) therapy has recently been reported (Porreca 2008).  The PRFE device emits a fixed dose of non-ionizing, non-thermal radio frequency energy, transmitted via an applicator pad placed adjacent to the patient’s dressed wound. Treatment is self-administered in the home or facility setting. This case series examines wound healing outcomes in a series of 224 Pressure ulcers.

Methods:            Consecutive patients receiving treatment with PRFE for Pressure Ulcers were registered into a wound database between 2005 and 2008. Cases originated from 39 geographically distributed US out-patient centers.  Most wounds had been unresponsive to previous therapies.   Data collected included subject age, gender, wound type and location, age of wound and dimensions.  PRFE therapy was prescribed as an adjunct to standard wound care protocols and assessed at 4 weeks.

Results:                224 wounds were included in the analysis (Stage II 20%, Stage III 20%, Stage IV 40%, Unspecified 20%).  Patients were elderly with median age 71 years (Mean 69, SD 15.1, Min 28, Max 96), and had complex co-morbidities.  Wounds were chronic with median wound age 6 months (mean 11, SD 14, Min 0.5, Max 84), and large (median surface area 10.8 cm², mean 37.06, SD 112.4, Min 0.15, max 1546).  In the first month of therapy, wound surface area decreased by a median of 46.4%.  Thirty Six percent (36%) of wounds reached 50% closure;  5.7% healed completely.  The wound healing rate (DSA/days) was 12.5 mm²/day, twice the rate among pressure ulcers treated with standard care (6mm²/day) in the control group of randomized trials.

Conclusions:      Pressure ulcers treated with Pulsed Radio Frequency Energy are found to have a substantial reduction in size in the first 4 weeks, and to heal at a rate twice that of wounds treated with standard, basic wound care.