different techniques have been used to treat the difficult problem of leg and
foot ulcers caused by venous stasis, pressure, or diabetes. Various
applications of ultrasound are among these techniques. To date there is little
clear evidence to support the contention that use of high or low frequency
ultrasound is beneficial.
Cochrane meta-analysis of randomized controlled trials of ultrasound therapy in
the treatment of pressure ulcers found three trials with a total of 146
patients. In the two trial comparing ultrasound to sham treatment, there was no
difference in healing rates. In a three arm trial that compared ultrasound and
UV light to laser and to standard treatment, there were no significant
differences in healing between the arms.
Cochrane review of randomized controlled trials of ultrasound therapy for venous
ulcers concluded that there was no evidence that low frequency ultrasound
improves healing of venous leg ulcers. There was some weak evidence from
poor-quality research that high-frequency ultrasound may increase the healing of
venous leg ulcers in the short term. All studies had unknown or high risk of
Advisory Secretariat of Ontario conducted a systematic review on interventions
to treat pressure ulcers in 2008. They concluded that “The efficacy of other
adjunctive physical therapies [electromagnetic therapy, low-level laser therapy,
ultrasound therapy, ultraviolet light therapy, and negative pressure therapy] in
improving complete closure of pressure ulcers has not been established.
study comparing low frequency ultrasound to standard therapy in healing venous
leg ulcers has reported positive results to the Clinical Trials database, but
this study has not yet been reported in peer reviewed literature. This study
was sponsored by the device manufacturer.
has published a study protocol for comparison of healing in diabetes-related
foot ulcers with low frequency ultrasonic debridement versus standard
debridement, which is projected to enroll over 100 patients, and will become one
of the larger studies in this field. This study, once completed and published,
may help better inform use of this technology.