| 332 | Case Study |
Treatment of full-thickness burns with noncontact low-frequency ultrasound Authors: Steven Kavros, DPM Background: Noncontact low-frequency ultrasound has been used to treat chronic lower and upper extremity ulcerations. This has been especially well received in the high risk population as an adjunct to standard of care therapies for acute and chronic wounds. Acute full thickness burns in the compromised patient can present additional problems with significant resultant morbidity. Three cases of full thickness burns will be reviewed with noncontact low-frequency ultrasound utilized as a primary treatment modality for wound healing. Case 1: 78 y.o female presents with type 2 diabetes mellitus, peripheral neuropathy, chronic critical limb ischemia, Charcot neuroarthropathy and end stage renal disease on hemodialysis. Patient developed a full thickness burn of her long finger after grasping a mug of hot water from the microwave. She presented with tissue loss and a wound extending into the subcutaneous tissue. This injury was in the same upper extremity as her AV fistula used for access in hemodialysis. Noncontact low-frequency ultrasound was used to treat the full thickness burn in conjunction with topical antimicrobial medication. Serial pictures reveal the healing process. Successful closure of the full thickness burn was accomplished in eight weeks in this compromised individual. Case 2: 74 y.o. male presents with an acute full thickness contact burn of the right calf. He is a type 2 diabetic with advanced sensory peripheral neuropathy of the foot and leg. This developed by his calf contacting the exhaust pipe while riding his motorcycle. He noticed blood in his boot after his ride. His wife noted the wound on his calf the next day. The burn became infected and he presented to the emergency department. He was placed on oral antibiotics and was referred the Vascular Wound Healing Center. This wound measured 4.0 cm x 4.0 cm, was full thickness without undermining or sinus tract formation. Multiple treatments with LFU and biologic dressings lead to full closure without further infection in 5 weeks. Case 3: 61 y.o male presented with full thickness burn of the foot. Only plantar surface of the foot was not affected. He is a type 2 diabetic with advanced sensory and motor peripheral neuropathy, CAD and renal insufficiency. The initial burn was sustained while camping. He placed his foot too close to the camp fire and subsequently melted the boot sustaining a Wagner Stage IV to the medial midfoot. The patient returned home and noticed the boot well adhered to the foot. He proceeded to soak his foot in hot water for over one hour trying to remove the melted boot. He further developed a large bullous formation of the remaining dorsum of the foot with partial and full thickness involvement. Noncontact low-frequency ultrasound was used for 10 weeks in conjunction with moist wound healing principles to heal the burn injuries. Conclusion: Noncontact low-frequency ultrasound has been very effective in the treatment of full thickness burns. Further investigation on its efficacy in burn management is warranted. |
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