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According to research suspected Deep Tissue Injuries (sDTI) deteriorate rapidly even with optimal treatment.[1] In our case series we evaluated if non-contact low frequency ultrasound (NLFU) would rescue the sDTIs from progressing to full thickness injuries for either sDTIs identified as present on admission (POA) or hospital acquired pressure ulcers (HAPU). Baharestani[2]reported that at 14 days after identification the intact sDTI evolved as follows: 9% were blistered/denuded; 23.5% necrotic/purple; 15% stage III/IV; and 50.5% discharged/expired.
Method:
A retrospective case series from November 2011 through September 2012 identified 17 patients (23 sDTI) treated with NLFU until the sDTI was no longer purple /maroon. The Wound, Ostomy, Continence nurse validated the sDTI and initiated the standard of care, including pressure relief. The sDTI was defined as the total area of discoloration [L X W= cm²]. Treatment with NLFU was administered daily for 5 days, and then 3 times per week.
Results:
An average of 9 NLFU treatments were administered over 15 days to the 17 patients (23 sDTIs). Of the sDTIs, 10 were POA and 13 were HAPU. Within the 10 POA ulcers the outcome was as follows: 7 stage I/II, and 3 Unstageable ulcers. Among the 13 HAPUs the outcome was: 9 resolved to stage I/II, 2 to stage III, and 2 to Unstageable ulcers. Interestingly, in the discharged patients treated with NLFU but without resolution of the sDTI’s purple/maroon color at discharge, 64% who received at least 6 treatments exhibited a reduction in severity of color and/or stage. Of those, 8 patients had a 53% reduction of color and/or stage.[³,4]
Conclusion:
In this case series both POA and HAPU sDTIs responded favorably to NLFU. Based on the encouraging outcomes identified, we concluded that patients benefit from at least 6 NLFU treatments. More formal research on NLFU is warranted.