Ultrasound evaluation of acute experimental and chronic clinical wounds

Background/aims: An ultrasonic pulse echo Imaging technique was used to visualise various characteristics of experimentally induced acute full‐thickness wounds. These characteristics were monitored over time as wound healing progressed. Data obtained from this work have been extrapolated to allow monitoring of healing and non‐healing wounds in a human clinical environment. Methods: Acute experimental full‐thickness wounds were monitored using pulsed ultrasound (20 MHz) over a period of 21 days. The scans were interpreted in the light of data obtained from previous studies, clinical observations and current knowledge of wound healing. Similarly, ultrasound scans of healing and nonhealing clinical wounds were evaluated over a 6‐week period. Ultrasound scans of amputated tissue were compared with the same site of histology to support scan evaluations of anatomical changes in ulcerated and adjacent tissue. Results: The serial ultrasound scans of acute experimental full‐thickness wounds demonstrated that changes in wounds could be observed and that specific events occurring during wound healing could be monitored, e.g., granulation tissue formation, reepithelialisation and wound contraction/fill. Specifically, these events were related to clinical observations of accumulation/synthesis of fibrotic (collageneous) tissue within the wound. Reepithelialisation of the wound could be monitored but was more problematic in quantitative evaluations. Conclusions: Ultrasound can be used to monitor non‐invasively and sequentially events that occur during acute wound healing. This information may be useful in extrapolating to healing and non‐healing clinical wounds and may provide a diagnostic tool to identify early signs of tissue breakdown prior to ulceration.