title: Therapeutic ultrasound treatment for excessive skin on the upper arms due to extensive weight loss after bariatric surgery: A single blind, randomised, controlled trial.
abstract: BACKGROUND
  Excessive skin is a side-effect of massive weight loss. The only evidence-based treatment for excessive skin is plastic surgery. Non-invasive treatments, therefore, need to be evaluated. The aim of this study was to investigate effects of therapeutic ultrasound treatment on excess skin on the upper arms after bariatric surgery.
  
  
  METHODS
  Fourteen patients were randomised to receive five treatments, each lasting for 30 minutes with active ultrasound treatment by CellsonicTM (Cellsonic Ltd) on one arm. The other arm served as control. The effect was evaluated objectively by measuring arm volume, circumference, and ptosis, and subjectively by a questionnaire where the patients assessed the effect of the treatment and amount and/or discomfort of the excess skin.
  
  
  RESULTS
  No statistical differences were observed in the objectively measured variables. Some patients reported perceived effects and a majority reported positive experiences of the treatment. No side-effects were reported.
  
  
  CONCLUSIONS
  This study could not find any objectively measured effect of ultrasound treatment on excessive skin after bariatric surgery. However, participants experienced relief of symptoms associated with excess skin, such as pain, looseness, and decreased skin burst, which indicates that ultrasonic treatment of patients with excessive skin should be further investigated.
authors.affiliation: a 1 Division of Nursing Science, Department of Medical and Health Sciences, University of Linköping , Linköping, Sweden.
authors.forename: Kristofer
authors.initials: K
authors.lastname: Bjerså
authors.affiliation: b 2 Department of Surgery/Gastrosurgical Research & Education, Institute of Clinical Sciences , Gothenburg, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Biörserud
authors.affiliation: b 2 Department of Surgery/Gastrosurgical Research & Education, Institute of Clinical Sciences , Gothenburg, Sweden.|c 3 Department of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg , Gothenburg, Sweden.
authors.forename: Monika
authors.initials: M
authors.lastname: Fagevik Olsén
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods*; D015992:Body Mass Index; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D016037:Single-Blind Method; D012867:Skin; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*; D034941:Upper Extremity; D015431:Weight Loss
keywords: Excess skin; ultrasound; weight loss