title: A painless method of ultrasonically assisted debridement of chronic leg ulcers: a pilot study.
abstract: OBJECTIVE
  Devitalized tissue in a recalcitrant leg ulcer is common and may impede healing. The aim of this study was to evaluate the use of a non-invasive low frequency ultrasound device to debride chronic leg ulcers as an adjunct to compression bandages therapy.
  
  
  METHODS
  19 patients with leg ulceration of at least 6 months were recruited. Low frequency ultrasound at 25kHz was delivered by a portable Sonaca--180 via a handheld probe, using normal saline as the irrigation/coupling medium. The ultrasound was applied for 10-20 seconds per probe head area onto the ulcer. Each leg underwent treatment at an interval of 2-3 weeks with compression bandages reapplied at the end of the treatment. Serial colour photographs were taken to evaluate the response at each visit.
  
  
  RESULTS
  Each patient received on average 5.7 treatments each ranged from 5-20 minutes depending on the ulcer size. Symptomatic relief (pain and odour reduction) was achieved in 6 patients. 7 patients achieved complete ulcer healing (mean ulcer size=4.72+/-SD 1.872cm(2)) but no response was observed in 8 patients. There were no major complications of the treatment which was relatively painless.
  
  
  CONCLUSIONS
  The application of low frequency ultrasound debridement may heal some recalcitrant ulcers when standard compression regimens have failed. It is cheap and does not require admission. The role of simple wound cleansing requires further investigation.
authors.affiliation: St. Thomas' Hospital, Academic Department of Surgery, Cardiovascular Division, London, UK. Justin.tan@yahoo.co.uk
authors.forename: J
authors.initials: J
authors.lastname: Tan
authors.forename: S
authors.initials: S
authors.lastname: Abisi
authors.forename: A
authors.initials: A
authors.lastname: Smith
authors.forename: K G
authors.initials: KG
authors.lastname: Burnand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D016896:Treatment Outcome; D014464:Ultrasonic Therapy; D014463:Ultrasonography