Noncontact Low Frequency Ultrasound in Conjunction with Negative Pressure Therapy to Aide in the Healing of an Abdominal Wound with Exposed Bowel

An 18 year old male with a history of ulcerative colitis status post subtotal colectomy with end illeostomy presents to the emergency department with acute onset abdominal pain and low ostomy output.  The patient was taken to the OR for an ex-lap with findings of extensive adhesions.  At post operative day 5 the midline abdominal wound dehisced and was packed with a wet to dry dressing.  Post operative day 9 the midline abdominal fascia dehisced exposing the bowel at the base of the wound.  Initial evaluation demonstrated a wound volume of 290cm³, 40% exposed bowel, 20% granular tissue, and 40% slough.  The bowel was draped with petroleum gauze, the remaining wound protected with restore contact layer, and Negative Pressure Wound Therapy was applied with a single layer of white foam covered by black foam and a pressure of 75mmHg.  The wound was reassessed two days later with no change and Low Frequency Non Contact Ultrasound was initiated with a frequency 40kHz for 10 minutes prior to the reapplication of the Negative Pressure Therapy.  After a total of 6 days and 4 ultrasound treatments, the patient was discharged home with 0% exposed bowel, 50% healed with a volume of 144cm³, 95% granular tissue, and only 5% slough.  In conclusion Noncontact Low Frequency Ultrasound in conjunction with Negative Pressure Wound Therapy is an effective treatment for abdominal wounds with exposed bowel.