Ultrasonic-assisted wound debridement for scleroderma digital ulcers

Abstract

Debridement is a key element of wound care. It involves the removal of devitalized tissue from the wound bed in order to allow wound healing. Microcirculatory ulcers in general and scleroderma ulcers in particular are extremely painful, very reactive and rather unwilling to accept aggressive local treatments of a mechanical type or surgical cleaning which can promote an abnormal phlogistic response with a necrotizing evolution. For the elimination of devitalized tissue is necessary to promote autolytic or enzymatic debridement with slow tendency towards healing frequently exposed to phlogistic infections furthermore slowing healing with high risk of gangrene and amputation. Ultrasonic-assisted wound debridement uses low frequency ultrasound waves showing three clinical effects: atraumatic selective tissue debridement, wound stimulatory effect and antibacterial activity. We compare healing time, infections and procedural pain of ultrasonic debridement with autolytic debridement as for Scleroderma digital Ulcers. There is evidence to show that Ultrasonicassisted wound debridement reduces the time of healing, needing for antimicrobial therapy, the procedural pain and consequently the cost to the healthcare system improving the patients' quality of life.

<p>Management of digital ulcers in systemic sclerosis</p>

“…67 A recent paper reported that ultrasoundassisted wound debridement reduced pain, necessity of antimicrobial therapy, and healing time in SSc patients. 68 The presence of infection should be carefully investigated during evaluation of the patient with DUs during SSc. Actually, the presence of infection is associated with a higher risk of local complications and reduced healing of DUs.…”