Advances in Clinical and Experimental Medicine
2014, vol. 23, nr 6, November-December, p. 969–975
Publication type: original article
Comparison of High-Frequency and MIST Ultrasound Therapy for the Healing of Venous Leg Ulcers
1 Department of Dermatology, Qazvin University of Medical Sciences, Qazvin, Iran
2 Department of General Surgery, Qazvin University of Medical Sciences, Qazvin, Iran
Background. Venous leg ulcers (VLUs) are a health problem in clinical care. Several options can be employed as adjuvant to standard treatment.
Objectives. We have aimed to analyze the effect of standard ulcer care alone with high-frequency ultrasound (HFU) and MIST ultrasound therapy on VLUs.
Material and Methods. Ninety patients with VLUs were assigned into the standard treatment, HFU and MIST ultrasound groups. All groups received the standard wound care. In the ultrasound groups, HFU and MIST ultrasound therapy was administered to wounds 3 times per week until the wound healed. Time of complete wound healing was recorded. Wound size, pain, and edema were assessed at baseline and after 2 and 4 months. Also, patients were instructed to contact our clinic monthly, and recurrence of VLUs was recorded for 6 months after complete wound healing. The data was analyzed using a Student’s t-test, ANOVA, c2, or Fisher’s exact test. P < 0.05 was considered significant.
Results. Mean time duration of complete wound healing in the first, second and third groups was 8.13 (SD 1.40), 6.10 (SD 1.47) and 5.70 (SD 1.57) months, respectively (p < 0.0001). Size of ulcer, mean degree of pain and edema in ultrasound therapy was decreased after the 4-month visit in comparison to the standard-treatment group (p = 0.01, p < 0.0001 and p < 0.0001, respectively). Also, our results don’t show any significant differences between groups in the recurrence of VLUs during a 6-month follow up after complete wound healing (p = 0.37).
Conclusion. Our results in the present study show the significant effectiveness of ultrasound therapy in wound healing. Differences between the two ultrasound therapy groups were not statistically significant.
ultrasound therapy, venous leg ulcers
- Moffatt C, Dorman M: Recurrence of leg ulcers within a community leg ulcer service. J Wound Care 1995, 4, 57–61.
- Grindlay A, MacLellan D: Inpatient management of leg ulcers: A costly option? Prim Intent 1997, 5, 24–26.
- Wienert V, Vanscheidt W, Rabe E: Leg ulcer due to venous insufficiency. In: Westerhof W. Leg ulcers: diagnosis and treatment. 1st ed. Amsterdam: Elsevier Science Publishers 1993, 83–113.
- Cherry GW, Hofman D, Cameron J, Poore SM: Bandaging in the treatment of venous ulcers. A European view. Ostomy Wound Manage 1996, 42, 13–18.
- Ryan TJ: The management of leg ulcers. 2nd ed. Oxford: Oxford University Press 1987, 1–101.
- Stücker M, Reich S, Robak-Pawelczyk B: Changes in venous refilling time from childhood to adulthood in subjects with apparently normal veins. J Vasc Surg 2005, 41, 296–302.
- O’Meara S, Cullum NA, Nelson EA: Compression for venous leg ulcers. Cochrane Database Syst Rev 2008, 4, CD000265.
- Trent JT, Falabella A, Eaglstein WH, Kirsner RS: Venous ulcers: pathophysiology and treatment options. Ostomy Wound Manage 2005, 51, 38–56.
- Hill OR: Ultrasound biophysics: a perspective. Br J Cancer 1982, 82, 46–51.
- Moffatt C, Martin R, Smithdale R: Leg ulcer management. Blackwell Publishing Ltd 2007.
- Kibler WB, Duerler K: Electrical stimulation and application of heat. In: DeLee & Drez’s Orthopaedic Sports Medicine: Principles and Practice. Eds.: DeLee J, Drez D, Miller MD, Saunders, Philadelphia 2003, 2nd ed., 349–351, 356–359.
- Cameron MH: Thermal agents: cold and heat, ultrasound, and electrical currents. In: Physical Agents in Rehabilitation: From Research to Practice. Ed.: Cameron MH, Saunders, St. Louis 2003, 2nd ed., 133–259.
- Busse JW, Bhandari M, Kulkarni AV, Tunks E: The effect of low-intensity pulsed ultrasound therapy on time to fracture healing: a meta-analysis. CMAJ 2002, 166, 437–441.
- Ernst E: Ultrasound for cutaneous wound healing. Phlebology 1995, 10, 2–4.
- Unger PG: Low-frequency, noncontact, nonthermal ultrasound therapy: a review of the literature. Ostomy Wound Manage 2008, 54, 57–60.
- Ennis WJ, Meneses P: Comprehensive wound assessment and treatment system. In: Falabella A, Kirsner R, eds. Wound Healing. Boca Raton, FL: Taylor and Francis 2005, 59–68.
- Chibnall JT, Tait RC: Pain assessment in cognitively impaired and unimpaired older adults: a comparison of four scales. Pain 2001, 92, 173–186.
- Brodovicz KG, McNaughton K, Uemura N, Meininger G, Girman CJ, Yale SH: Reliability and feasibility of methods to quantitatively assess peripheral edema. Clin Med Res 2009, 7, 21–31.
- Ennis WJ, Valdes W, Gainer M, Meneses P: Evaluation of clinical effectiveness of MIST ultrasound therapy for the healing of chronic wounds. Adv Skin Wound Care 2006, 19, 437–446.
- Ennis WJ, Foremann P, Mozen N, Massey J, Conner-Kerr T, Meneses P: Ultrasound therapy for recalcitrant diabetic foot ulcers: results of a randomized, double-blind, controlled, multicenter study. Ostomy Wound Manage 2005, 51, 24–39.
- Kavros SJ, Miller JL, Hanna SW: Treatment of ischemic wounds with noncontact, lowfrequency ultrasound: the Mayo clinic experience, 2004–2006 Adv Skin Wound Care 2007, 20, 221–226.
- Kavros SJ, Schenck EC: Use of noncontact low-frequency ultrasound in the treatment of chronic foot and leg ulcerations: A 51-patient analysis. J Am Podiatr Med Assoc 2007, 97, 95–101.
- Gehling ML, Samies JH: The effect of noncontact, low-intensity, low-frequency therapeutic ultrasound on lowerextremity chronic wound pain: A retrospective chart review. Ostomy Wound Manage 2007, 53, 44–50.
- Nelson E, Cullum N, Jones J: Venous leg ulcers. British Medical Journal (Clinical Research Edition) 2006, 172, 1447–1452.