Clinical Case Series: Management of Various Types of Wounds with the Use of Noncontact Low Frequency Ultrasound (NLFU) in a Long Term Acute Care Hospital

Annielyn Azor - Ocampo, BSN, RN, CWOCN, Madonna Rehabilitation Hospital, Lincoln, NE
Clinical Problem: A review of patients charts (n=6) was conducted with various types of wounds not responding to typical wound care products, common diagnoses of Hypertension, Hyperlipidemia, Respiratory insufficiency, Malnutrition and Anemia in relation to other systemic factors affecting wound healing. Patient’s age ranged from 28 to 90 y/o.

Past Management: Wound care products utilized to promote wound healing include low airloss therapy and fluid simulation support surfaces.

Patient A: stage 4 pressure injury to coccyx managed by calcium alginate, hypochlorous acid

Patient B: stage 4 pressure injury to coccyx with exposed bone managed by antimicrobial barrier silver dressing

Patient C: deep tissue injury to coccyx managed by balsam peru, castor oil ointment

Patient D: full thickness non-granulating perineal wound related to trauma from vehicular accident managed by hypochlorous acid

Patient E: stage 4 pressure injury to coccyx managed by sodium hypochlorite acid

Patient F: full thickness wound to left lower leg from hematoma with fat necrosis managed by sodium hypochlorite acid

Current Approach: Use of NLFU as adjunct treatment to wound care, initial wound volume ranged from 12cm2 to146 cm2

Patient A: NPWT, three NLFU treatments for 1 week

Patient B: NPWT, ten NLFU treatments for 3 weeks

Patient C: Enzymatic debrider, five NLFU treatments for 1.5 weeks

Patient D: Mafenide acetate cream, five NLFU treatments for 1.5 weeks

Patient E: NPWT, two NLFU treatments

Patient F: NPWT, thirteen NLFU treatments for 4 weeks

Outcomes: Average wound volume reduction at 60%. Three patients with average of 76% wound volume reduction, one patient with 42% reduction after 2 NLFU treatments inspite of being one week apart from initial treatment.  


The addition of NLFU as an adjunct treatment to standard of care for treating various types of wounds was found to be highly effective, provided positive outcomes, reduced wound volumes.