• 1

    Young SR, Dyson M: Effect of therapeutic ultrasound on the healing of full thickness excised skin lesions. .Ultrasonics 28::175. ,1990. .

  • 2

    Harvey W, Dyson M, Pond JB, et al: The stimulation of protein synthesis in human fibroblasts by therapeutic ultrasound. .Rheumatol Rehabil 14::237. ,1975. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Dyson M: “The Effect of Ultrasound on the Rate of Wound Healing and the Quality of Scar Tissue,” in Proceedings of the International Symposium on Therapeutic Ultrasound, Canadian Physiotherapy Association, Winnipeg, Manitoba. ,1981. .

    • PubMed
    • Export Citation
  • 4

    Jackson BA, Schwane JA, Starcher BC: Effect of ultrasound therapy on the repair of Achilles tendon injury in rats. .Med Sci Sports Exerc 23::171. ,1991. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Gogia PP: Physical therapy modalities for wound management. .Ostomy Wound Manage 42::46. ,1996. .

  • 6

    Webster DF, Pond JB, Dyson M, et al: The role of cavitation in the in vitro stimulation of protein synthesis in human fibroblasts by ultrasound. .Ultrasound Med Biol 4::343. ,1978. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Sussman C, Dyson M: “Therapeutics and Diagnostic Ultrasound,” in Wound Care: A Collaborative Practice Manual for Physical Therapists and Nurses, 2nd Ed, p 596, Aspen Publications, New York. ,2001. .

    • PubMed
    • Export Citation
  • 8

    Dijkmans PA, Juffermans LJ, Musters RJ, et al: Microbubbles and ultrasound: from diagnosis to therapy. .Eur J Echocardiogr 5::245. ,2004. .

  • 9

    Dinno MA, Dyson M, Young SR, et al: The significance of membrane changes in the safe and effective use of therapeutic and diagnostic ultrasound. .Phys Med Biol 34::1543. ,1989. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Maxwell L, Collecutt T, Gledhill M, et al: The augmentation of leukocyte adhesion to endothelium by therapeutic ultrasound. .Ultrasound Med Biol 20::383. ,1994. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Ito M, Azuma Y, Ohta T, et al: Effects of ultrasound and 1,25 dihydroxyvitamin D3 on growth factor secretion in co-cultures of osteoblasts and endothelial cells. .Ultrasound Med Biol 26::161. ,2000. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Doan N, Reber P, Meghji S, et al: In vitro effects of therapeutic ultrasound on cell proliferation, protein synthesis, and cytokine production by human fibroblasts, osteoblasts, and monocytes. .J Oral Maxillofac Surg 57::409. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Young SR, Dyson M: The effect of therapeutic ultrasound on angiogenesis. .Ultrasound Med Biol 16::261. ,1990. .

  • 14

    Young SR, Dyson M: Macrophage responsiveness to therapeutic ultrasound. .Ultrasound Med Biol 16::809. ,1990. .

  • 15

    Francis CW, Onundarson PT, Carstensen EL, et al: Enhancement of fibrinolysis in vitro by ultrasound. .J Clin Invest 90::2063. ,1992. .

  • 16

    Reher P, Harris M, Whiteman M, et al: Ultrasound stimulates nitric oxide and prostaglandin E2 production by human osteoblasts. .Bone 31::236. ,2002. .

  • 17

    Bacharach JM, Rooke TW, Osmundson PJ, et al: Predictive value of transcutaneous oxygen pressure and amputation success by use of supine and elevated measurements. .J Vasc Surg 15::558. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Palumbo PJ, Melton LJ: “Peripheral Vascular Disease and Diabetes,” in Diabetes in America (NIH Publication No. 85-1468), US Government Printing Office, Washington, DC. ,1985. .

    • PubMed
    • Export Citation
  • 19

    Pecoraro RE, Reiber GE, Burgess EM: Pathways to diabetic limb amputation: basis for prevention. .Diabetes Care 13::513. ,1990. .

  • 20

    American Diabetes Association: Diabetes: 1996 Vital Statistics, American Diabetes Association, Alexandria, VA. ,1996. .

    • PubMed
    • Export Citation
  • 21

    Montori VM, Kavros SJ, Walsh EE, et al: Intermittent compression pump for nonhealing wounds in patients with limb ischemia, the Mayo Clinic experience (1998–2000). .Int Angiol 21::360. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Vella A, Carlson LA, Blier B, et al: Circulator boot therapy alters the natural history of ischemic limb ulcerations. .Vasc Med 5::21. ,2000. .

  • 23

    Kottke FJ, Stillwell GK, Lehmann JF: “Diathermy and Superficial Heat and Cold Therapy,” in Krusen’s Handbook of Physical Medicine and Rehabilitation, p 310, WB Saunders, Philadelphia. ,1982. .

    • PubMed
    • Export Citation
  • International Programme on Chemical Safety: Environmental Health Criteria 22: Ultrasound, World Health Organization, Geneva. ,1982. .

    • PubMed
  • Johns LD: Non-thermal effects of therapeutic ultrasound: the frequency resonance hypothesis. .J Athl Train 37::293. ,2002. .

    • PubMed
    • Search Google Scholar

Use of Noncontact Low-Frequency Ultrasound in the Treatment of Chronic Foot and Leg Ulcerations

A 51-Patient Analysis

Steven J. Kavros Department of Orthopedic Surgery and Gonda Vascular Wound Healing Center, Mayo Clinic, Rochester, MN.

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Erik C. Schenck Department of Physical Medicine and Rehabilitation and Gonda Vascular Wound Healing Center, Mayo Clinic, Rochester, MN.

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Background: A feasibility study was conducted to characterize the effects of noncontact low-frequency ultrasound therapy for chronic, recalcitrant lower-leg and foot ulcerations.

Methods: The study was an open-label, nonrandomized, baseline-controlled clinical case series. Patients were initially treated with the Mayo Clinic standard of care before the addition of or the switch to noncontact low-frequency ultrasound therapy. We analyzed the medical records of 51 patients (median ± SD age, 72 ± 15 years) with one or more of the following conditions: diabetes mellitus, neuropathy, limb ischemia, chronic renal insufficiency, venous disease, and inflammatory connective tissue disease. All of the patients had lower-extremity ulcers, 20% had a history of amputation, and 65% had diabetes. Of all the wounds, 63% had a multifactorial etiology, and 65% had associated transcutaneous oximetry levels below 30 mm Hg.

Results: The mean ± SD treatment time of wounds during the baseline standard of care control period versus the noncontact low-frequency ultrasound therapy period was 9.8 ± 5.5 weeks versus 5.5 ± 2.8 weeks (P < .0001). Initial and end measurements were recorded, and percent volume reduction of the wound was calculated. The mean ± SD percent volume reduction in the baseline standard of care control period versus the noncontact low-frequency ultrasound therapy period was 37.3% ± 18.6% versus 94.9% ± 9.8% (P < .0001).

Conclusions: Using noncontact low-frequency ultrasound improved the rate of healing and closure in recalcitrant lower-extremity ulcerations. (J Am Podiatr Med Assoc 97(2): 95–101, 2007)

Corresponding author: Steven J. Kavros, DPM, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
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