Clinical effectiveness of noncontact, low-frequency, nonthermal ultrasound in burn care

Most burns are thermal and can be treated on an outpatient basis with conventional care that includes daily dressing changes, debridement, and infection control. These treatments can exacerbate pain associated with burns. Noncontact, low-frequency, nonthermal ultrasound therapy is delivered via sterile saline mist and has been used to cleanse and debride a variety of acute and chronic wounds, including burns, with less associated pain. This case series study evaluated low-frequency, nonthermal ultrasound therapy as an adjunct to conventional burn care in six nonrandomly selected outpatients with partial- to full-thickness thermal burns. The effectiveness of low-frequency, nonthermal ultrasound was assessed through changes in wound bed composition, exudate characteristics, and pain. Patients rated pain using a 10-point numerical rating scale (0 = no pain; 10 = extreme pain). Noncontact ultrasound treatments of 3 to 20 minutes (depending on wound size) were administered up to five times weekly. Conventional treatments included antibacterial ointments and nonadherent moist dressings. Treatment continued until wounds were predominately granulation tissue. As few as one noncontact ultrasound treatment caused slough to lift easily and granulation tissue to develop quickly. Pain rapidly resolved and all wounds healed and closed without surgical intervention. In this case series study, noncontact ultrasound treatment was an effective adjunct to conventional burn care.