title: Reduction of pressure ulcer size with high-voltage pulsed current and high-frequency ultrasound: a randomised trial.
abstract: OBJECTIVE
  International guidelines recommend the use of ultrasound (US) and electrical stimulation (ES) for treating chronic and recurrent pressure ulcers (PUs). The methodology of these procedures, however, still needs elaboration and confirmation by clinical studies. This parallel-group, randomised, single-blind, prospective, controlled clinical trial was conducted to determine whether by using high-frequency ultrasound (HFUS) and high-voltage monophasic pulsed current (HVMPC), the rate of change in the area of older patients' PUs can be accelerated.
  
  
  METHODS
  Patients were randomly assigned to receive either: standard wound care (SWC) involving supportive care and topical treatments; SWC+US (1MHz; 0.5 W/cm2; 20%; 1-3 minutes/cm2); or SWC+ES (HVMPC, 154 µs, 100 pps, 100 V, 250 µC/sec, 50 minutes/day). US and ES were administered once a day, 5 days a week. The primary outcome was change in PU surface area measured against baseline after 6 weeks of treatment with SWC, SWC+US, and SWC+ES.
  
  
  RESULTS
  We recruited 77 patients, aged 60-95 years (80% aged over 70 years of age), with 88 Category II, III and IV PUs were enrolled in the study. The percentage reduction in the surface area of PUs at the end of treatment was significantly greater in the SWC+US group (mean ± standard deviation, 77.48±11.59 %; p=0.024) and the SWC+ES group (76.19±32.83%; p=0.030) versus the control group (48.97±53.42%). The SWC+ES group also had a significantly greater proportion of PUs that decreased in area by at least 50% or closed than the control group (p=0.05 and 0.031, respectively). The SWC+US and SWC+ES groups were not statistically significant different regarding treatment results. Clinical side effects were not recorded.
  
  
  CONCLUSIONS
  The results show that HFUS and HVMPC are comparable regarding their effectiveness in reducing the size of PUs in older people.
  
  
  BACKGROUND
  The authors have nothing to disclose. All research activities were funded by the Academy of Physical Education, Katowice, Poland.
authors.affiliation: Department of Physical Therapy, Academy of Physical Education, Mikolowska 72B, 40-065 Katowice. Poland.|Institute of Medical Science, Katowice School of Economics, Harcerzy Wrzesnia 3, 40-659 Katowice. Poland.
authors.forename: A
authors.initials: A
authors.lastname: Polak
authors.affiliation: Department of Physical Therapy, Academy of Physical Education, Mikolowska 72B, 40-065 Katowice. Poland.|Institute of Physical Therapy, Public High School of Medicine, Katowice 68, 45-060 Opole, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Taradaj
authors.affiliation: Department of Physical Therapy, Academy of Physical Education, Mikolowska 72B, 40-065 Katowice. Poland.|Caritas Skilled Nursing Facility, Wolnosci 30, 41-700 Ruda Slaska, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Nawrat-Szoltysik
authors.affiliation: Department of Physical Therapy, Academy of Physical Education, Mikolowska 72B, 40-065 Katowice. Poland.
authors.forename: M
authors.initials: M
authors.lastname: Stania
authors.affiliation: Department of Medical Biophysics, Medical University of Silesia, Medyków 18 bud. C2, 40-752 Katowice. Poland.
authors.forename: P
authors.initials: P
authors.lastname: Dolibog
authors.affiliation: Department of Medical Biophysics, Medical University of Silesia, Medyków 18 bud. C2, 40-752 Katowice. Poland.
authors.forename: E
authors.initials: E
authors.lastname: Blaszczak
authors.affiliation: Institute of Physical Education, Jan Długosz Academy, Waszyngtona 4, 42-200 Czestochowa, Poland.
authors.forename: R
authors.initials: R
authors.lastname: Zarzeczny
authors.affiliation: Department of Motor Behaviour, Academy of Physical Education, ul. Mikołowska 72B, 40-065 Katowice. Poland.
authors.forename: G
authors.initials: G
authors.lastname: Juras
authors.affiliation: Department of Medical Biophysics, Medical University of Silesia, Medyków 18 bud. C2, 40-752 Katowice. Poland.
authors.forename: A
authors.initials: A
authors.lastname: Franek
authors.affiliation: Department of Physical Therapy, Academy of Physical Education, Mikolowska 72B, 40-065 Katowice. Poland.|Department of Internal Medicine, Specialist Hospital, Chelmonskiego 28, 43-600 Jaworzno, Poland.
authors.forename: C
authors.initials: C
authors.lastname: Kucio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D006801:Humans; D008875:Middle Aged; D003668:Pressure Ulcer / Q000628:therapy*; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D014464:Ultrasonic Therapy; D014945:Wound Healing
keywords: electrical stimulation; pressure ulcer; ultrasound; wound healing