Pulsed radio frequency energy adjunctive treatment administered with negative pressure wound therapy of a non-healing pressure ulcer in a patient with spinal cord injury

Summary

A patient with a 12-year old, indolent, recalcitrant pressure ulcer arising from spinal cord injury was treated with local wound care, silver antimicrobials and negative pressure wound therapy with minimal results. Pulsed radio frequency energy (PRFE) therapy was added and the wound responded rapidly, reaching 92% closure in 2 months, and complete closure in 4 months of PRFE treatment.

Background 

Pressure ulcers in patients with spinal cord injury may become chronic and resistant to treatment.  Complex treatment regimens and adjuvant treatments often are necessary, and results may still be uncertain.

Case 

A 60-year-old male with quadriplegia and numerous co-morbid conditions presented with an indolent stage IV pressure ulcer of 12-year's duration.  The wound was treated with topical wound care, negative pressure wound therapy and silver antimicrobials. The wound responded minimally and erratically and then worsened after elective surgery.  Pulsed radiofrequency energy (PRFE) was added to the treatment protocol to trigger the biological responses of natural wound healing.

Results

With twice-daily outpatient, self-administered PRFE treatment, a 67% reduction wound volume was noted at 2 months. With 4 months of PRFE, this 12-year old wound had healed completely.

Conclusion 

Pulsed radio frequency energy was an extremely beneficial adjunct treatment along with negative pressure wound therapy of a long-term chronic stage IV pressure ulcer in a patient with spinal cord injury.  In light of the robust response of this complex, indolent wound, further investigations into this promising, novel technology are warranted.

Keywords: 

spinal cord injury, SCI, quadriplegia, pressure ulcer, pulsed radiofrequency energy, PRFE, wound healing, negative pressure wound therapy, NPWT, VAC, quality of life, QOL.