Wound Debridement with 25 kHz Ultrasound
Lippincott Williams & Wilkins
Advances in Skin & Wound Care
Several methods of wound debridement are described in the literature and are available to health care providers who specialize in wound management. Methods include the use of sharp surgical instruments; mechanical methods, such as whirlpool and pulsed lavage with suction; proteolytic and collagenolytic enzymes; autolysis; and sterile fly larvae (maggots). The use of surgical debridement is generally considered the most efficient method when performed by a skilled physician, who may in one session use his or her discretion to excise some viable tissue along with necrotic tissue in the wound. Sharp debridement performed in a clinical setting is a less aggressive procedure performed by physicians and other qualified health care practitioners. This method selectively removes eschar and slough as well as adherent fibrin, the latter with significant difficulty and time consumption. Frequently, sharp, selective removal of nonviable tissue is limited in efficacy owing to only partial removal of fibrin and/or intolerable pain experienced by the patient. The other debridement methods mentioned are primarily intended for selective removal of eschar, slough, and fibrin, of which fibrin may require several days to a few weeks for complete removal.
The purpose of this article is to describe a new type of debridement that uses ultrasound technology to remove necrotic tissue. In the authors' preliminary experience, this method appears to have the potential to be a breakthrough for wound cleansing and debridement of adherent fibrin.