Abstract: Treatment of Deep Tissue Pressure Injuries with Non Contact Low-frequency Ultrasound Using the Honaker Suspected Deep Tissue Injury Severity Scale to Track Improvement (50th Annual Conference)

Monica Koch, BSN, RN, CWON¹, Lisa Berning, BSN, RN, CWOCN, CFCN², Lynne Cowley, BSN, RN, CWOCN, WCC¹, Karen Murnan, RN, WCC, OMS¹, Jenna Wilkening, BSN, RN, CWCN¹ and Julia Mahoney, BSN, RN, CEN¹, (1)Wound Ostomy Continence, TriHealth Good Samaritan Hospital, Cincinnati, OH, (2)Wound Ostomy Continence, TriHealth; Good Samaritan Hospital, Cincinnati, OH

Background: According to NPUAP definitions, Deep Tissue Pressure Injuries (DTPI – formerly sDTI) can result from intense and/or prolonged pressure and shear forces at the bone-muscle interface and may evolve rapidly to reveal the actual extent of tissue injury (stage 3 or 4), or may resolve without tissue loss¹. Honaker and others have published promising results using non-contact low-frequency ultrasound (NCLFU) to treat sDTIs in an attempt to prevent progression to full thickness ulcers, finding significant decrease in severity among sDTIs treated with NCLFU compared to those receiving the standard of care². Honaker has also developed and tested a severity scale (HSDTISS) using surface area, skin integrity and color as parameters to accurately diagnose wound severity³.

Clinical approach: This 500+ bed Midwest teaching hospital began using adjunctive NCLFU in addition to standard of care (offloading, nutrition support, balsum of Peru ointment) to treat DTPIs, but had difficulty quantifying improvement. For this case series, the HSDTISS was used to document and track the evolution of each DTPI.

Outcome: 5 patients with deep tissue pressure injuries were treated with at least 3 treatments of NCLFU. They had variation in demographics and comorbidities. The HSDTISS was used to measure the severity of the injury and photos were taken for comparison. These 5 cases all show a decrease in severity as judged by the HSDTISS.

Conclusion and Limitations: Patients receiving NCLFU had an improvement in their DTPIs in size, color, and depth of injury. The HSDTISS was useful in comparing the severity of the wound to its starting point but may not capture all changes since the percentages of tissue types are not quantified. This study was limited by the lack of controls, small sample size and short length of stay with no ability to follow till DTPI resolution.

CS33 Treatment of Deep Tissue Pressure Injuries with Non Contact Low-frequency Ultrasound Using the Honaker Suspected Deep Tissue Injury Severity Scale to Track Improvement