title: Acoustic pressure wound therapy for management of mixed partial- and full-thickness burns in a rural wound center.
abstract: Infection, pain, and cosmetically unacceptable scarring frequently complicate full-thickness burns. Outpatient management can be difficult without specialized care. A retrospective case series study was conducted in a rural wound center lacking specialized burn care to assess the clinical effectiveness of acoustic pressure wound therapy, a noncontact low-frequency, nonthermal ultrasound wound therapy that accelerates healing through positive pressure, stimulating fibroblasts, clearing bacteria and debris, and relieving pain. Data from the records of 14 consecutively treated outpatients (age range 5 months to 78 years old) with mixed partial- and full-thickness burns involving the trunk, extremities, or both, averaging 7% of body surface area (range: 1% to 24%), were reviewed. Patients received acoustic pressure wound therapy with standard burn care. Burn thickness was determined by clinical appearance. Treatment effectiveness was evaluated based on scarring characteristics of healed wounds (ie, cosmetic appearance) and pain resolution. Pain was patient-rated using a 10-point visual analog scale (0 = no pain, 10 = severe). Patients were followed for 6 months post-healing. Pain improved with therapy (range: two to 10 treatments). No patient required hospitalization or developed complications related to infection. Pliable, nonhypertrophic scars developed in 86% of patients and hypertrophic scars developed in 14%. Repigmentation was seen in 79% of patients, with only minor irregularities; hypopigmentation occurred in 21%. Scars available for follow-up (71%) remained unchanged. Acoustic pressure wound therapy with standard burn care was found to heal mixed partial- and full-thickness burns and reduced pain in outpatients, resulting in cosmetically acceptable scarring without infectious complications, surgery, or skin grafts and may prove beneficial for inpatient management of extensive full-thickness burns. Further study is warranted.
authors.affiliation: Regional Medical Center of Orangeburg and Calhoun Counties, Orangeburg, SC, USA.
authors.forename: John
authors.initials: J
authors.lastname: Samies
authors.forename: Marie
authors.initials: M
authors.lastname: Gehling
mesh_terms: D000162:Acoustics / Q000295:instrumentation; D000293:Adolescent; D000328:Adult; D000368:Aged; D001830:Body Surface Area; D002056:Burns / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000453:epidemiology / Q000209:etiology; D019317:Evidence-Based Medicine; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D019035:Rural Health Services; D017592:Skin Care / Q000379:methods / Q000451:nursing; D013997:Time Factors; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods*; D014945:Wound Healing