Because of legal restrictions, MOMSCIS cannot give specific medical advice. The following information is not a substitute for the personal care or advice of your physician. Please discuss any concerns with your physician regarding your medical care. Physicians in the Physical Medicine & Rehabilitation Department at the University of Missouri-Columbia are available to evaluate patient records, and can set up a clinic visit for a medical evaluation. The PM&R Department does extensive treatment of individuals with spinal cord injuries using a wide variety of physical therapies and state-of-the-art medications. Individuals with spinal cord injuries can be examined and treated on an outpatient or inpatient basis. For more information about the PM&R services available or to schedule a clinic visit, telephone the clinic at (573) 884-0033.

Low-frequency ultrasound is new healing tool at Rusk

By Larry D. Nossaman
Senior Information Specialist

Ultrasound has become a new tool for medical professionals to use to promote wound healing, according to Michael A. Acuff, M.D., Spinal Cord Injury Specialist Physician at Rusk Rehabilitation Center in Columbia, Mo., and medical director of the Missouri Model Spinal Cord Injury System.

“Poor wound healing is a major problem for individuals with spinal cord injury (SCI),” Dr. Acuff said. “Any treatment plan must utilize a combination of treatments in order to be effective. These treatments include proper nutrition, pressure relief, positioning, stimulating the metabolism with hormones, and now stimulating the cells in the wound bed directly using ultrasound.”

He said the patient and physician must do the best they can do in each area in order for the best wound healing to occur. “If the patient continues his cigarette smoking, for example, and their wound is not healing, you have to question their commitment,” Dr. Acuff said.

Ultrasound is the creation of sound waves which are out of the range of human hearing. Low-frequency (LF), low-intensity sound waves are used to treat wounds in the system in use at Rusk since mid-May, 2005.

“In the past, there was evidence that LF ultrasound was beneficial for healing wounds, but the federal Food and Drug Administration (FDA) would not grant approval because there were no scientific studies documenting these benefits,” Dr. Acuff said. “That has now changed, and LF ultrasound does have FDA approval because there is scientific evidence of its effectiveness, not only in reducing bacteria in the wound area but for promoting healing in the wound bed itself.”

Sound waves are directed at the wound from a distance of ½-inch to 1 inch from the wound bed. The sound waves propel a saline solution mist toward the wound area. Dr. Acuff said there are five primary beneficial effects of the LF ultrasound treatments:

• LF Ultrasound loosens the debris (dead cells and other matter) from the wound area so it can be washed away. This activity is called debridement.
• LF Ultrasound significantly decreases the bacteria content of the wound area. Bacteria can impair or inhibit wound healing.
• LF Ultrasound improves the growth of capillary blood vessels to improve circulation in the area surrounding the wound. It may also decrease swelling and allow more beneficial things to get to the cells in the wound (nutrients, oxygen, etc.).
• LF Ultrasound stimulates the growth of fibroblast cells – connective tissues which fill in the wound area to protect the area and promote healing.
• LF Ultrasound increases the movement of fibroblast cells into the wound area.

The LF ultrasound treatments are given to inpatients and outpatients at Rusk. Nurses or physical therapists administer the five- to 10-minute treatments three to five times a week.

“I’m excited and pleased that we are able to offer these treatments now at Rusk,” Dr. Acuff said. “We will be using these treatments to improve wound care in patients who have pressure sores or surgical wounds, but they can be used on every type of wound, even those caused by individuals with diabetes.”

So far, there have been no reasons to discourage use of LF ultrasound to treat wounds, he said.