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Acta Phlebologica 2018 April;19(1):28-32

DOI: 10.23736/S1593-232X.18.00409-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Ultrasonic debridement: efficacy and homely feasibility

Stefano MANCINI 1, 2 , Fabrizio MARIANI 2, 3, Giuseppe BOTTA 1

1 Unit of Phlebology, Santa Maria Alle Scotte Hospital, University of Siena, Siena, Italy; 2 The Compression Therapy study Group (CTG), Genoa, Italy; 3 Multidisciplinary Joint Committee in Phlebology, European Board of Phlebology UEMS Bruxelles, Bruxelles, Belgium


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BACKGROUND: The aim of this study is to evaluate the efficacy of ultrasonic debridement at low frequency comparing with surgical one after local anesthesia and, consequently, homely feasibility, by nursing staff too.
METHODS: Fifty patients with active venous ulcers present for 3 to 12 months with fibrinous bed were enrolled and divided at random in two groups of 25 patients. In the study group we performed an ultrasonic debridement, while in the control group a classic surgical treatment, both after local anesthesia with prilocaine 2% + lidocaine 2% cream for 20 minutes. The same ultrasonic parameters were utilized for all cases: low sweet, power, vibration and irrigation flow. Ultrasonic debridement consists in two phase: in the first we treated lesion edge for 2 minutes with the back of the handpiece for anesthetic reason, while in the second we treated the fibrinous bed. Debridement pain were evaluated with Visual Analogical Scale.
RESULTS: Good debridement was reached in all cases of the study group, while in the surgical group was only in 80% the cases (20/25). In 5 cases debridement were interrupted for pain. Study group VAS was 1.52 points, while control group VAS was 3.2 points. Oral analgesic drugs needed in the first 24 hours only after surgical debridement. It did not need to modify ultrasonic parameters. No hemorrhagic complications were registered.
CONCLUSIONS: Ultrasonic debridement demonstrated to be efficacy to clean ulcers’ bed without pain, much to be used in home management and by nursing staff too.


KEY WORDS: Debridement - Varicose ulcers - Ultrasonics

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