Use of Non contact Low Frequency Ultrasound to Accelerate Healing of Pressure Ulcers in High Acuity Rehabilitation Patients

Our rehabilitation facility admits a patient population at high risk for developing pressure ulcers (PU’s) due to sensory deficits, impaired mobility, poor nutrition and existing PU’s.  To address this high-acuity population, from November 2013 to August 2014, our facility incorporated use of noncontact, low-frequency ultrasound (NLFU) as an adjunct therapy into our wound protocol.  A total of 18 patients (21 wounds) including Deep tissue injury (DTI), Stage III and Stage IV pressure ulcers were treated.  Weekly treatments included 2-3x’s/week (n=17) or 5x’s/week (n=1). These wounds fell into one of three groups; responding (>15% reduction), poor responders (<15% reduction) and non-responders (no reduction). 

A total of 16 patients (21 wounds, 76.2%) were responders, treated an average of 17 times over 6.7 weeks with an average wound volume reduction of 67%.  Of these, 4 patients with DTI present on admission were  fully healed at time of discharge, and 3 previously planned surgeries including surgical closure via flap were no longer required.  Two patients (2 wounds, 9.5%) were considered poor responders, treated an average of 14 times over 4.5 weeks with an average wound volume reduction of 12%.  Three patients (3 wounds, 14.3%) were non-responders, treated an average of only 7 times over 2.4 weeks with an average wound volume increase of 49%. Increase was attributed to surgical debridement. 

The addition of NLFU as an innovative process to our standard of care for treating PU’s was found to be highly effective.  Average length of stay (ALOS) for these patients  compared to a similar population from last year decreased from 46 days to 35 days. By following recommended guidelines, MIST treatments were discontinued in  poorly responding patients to minimize treatment costs, while accelerating healing, eliminating surgical costs and decreasing ALOS in the responding population.