Clinical Case Series: Use of Noncontact, Low-Frequency Ultrasound Therapy (NLFUT)* to Improve Outcomes of Non-healing Graft Sites

Purpose:  This clinical case series is to illustrate the benefits of using NLFUT* for non-healing graft sites.

Problem:  Three patients presented with non-healing graft sites.  Patient A had left fibular free flap related to radical neck dissection.  Patient B had transradial forearm osteocutaneous free flap for reconstruction of mandible.  Patient C had 15% total body surface area full-thickness burn with split-thickness mesh autografting.

Past Management:  Patient A was treated with hydrofiber Ag** and light compression.  Patient B was treated with silver fabric dressing±.   Patient C was treated with antibiotic ointment on non-adhering dressings and with wet to dry dressings.

Current Approach:  Patient A treated with NLFUT* then wound dressed with silver foam dressing+ followed by light compression wrap.  Patient B treated with NLFUT* then wound dressed with silver fabric dressing±.  Patient C was treated with NLFUT* then wound dressed with hydrofiber Ag**.

Outcomes: 

Patient A - NLFUT* facilitated removal of biofilm, decreased hypertrophic granulation tissue and enhanced epithelialization.  The periwound discoloration improved.  Experienced 9% decrease volume in one week. 

Patient B - NLFUT* facilitated removal of biofilm and growth of granulation tissue over exposed tendon.  Experienced total volume reduction of 83.3% in 3 weeks.

Patient C -  NLFUT* facilitated removal of necrotic tissue and enhanced epithelialization.  Patient able to increase participation in physical therapy due to decrease in pain associated with graft sites.

Conclusion:  Noncontact, Low-Frequency Ultrasound Therapy (NLFUT)* is beneficial to accelerating non-healing graft sites and decreasing pain.

<sub>*Mist Therapy
** Aquacel Ag
+ Mepilex Ag
± Silverlon</sub>