Open AccessUse of high‐resolution ultrasound to monitor the healing of leg ulcers: a prospective single‐center study
Author(s) -
Kuhn Christoph,
Angehrn Fiorenzo
Publication year - 2009
Publication title -
skin research and technology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.521
H-Index - 69
eISSN - 1600-0846
pISSN - 0909-752X
DOI - 10.1111/j.1600-0846.2008.00342.x
Subject(s) - medicine , single center , prospective cohort study , surgery , wound healing , ultrasound , cls upper limits , dermatology , radiology , ophthalmology
Background: The quality and extent of leg ulcer healing in deeper skin layers remains poorly defined using standard visual inspection alone. High‐resolution ultrasound (HR‐US) offers a non‐invasive, quantitative and objective assessment of dimensional and structural changes deep within the wound. Methods: In a prospective, single‐center study, healing of chronic, treatment‐resistant leg ulcers was monitored by standard photography and HR‐US. Results: Twenty patients with 22 ulcers were enrolled. After study entry, treatment comprised continuation of conventional management ( n =4) or application of Apligraf ® ( n =17) or Thiersch ( n =1). All ulcers receiving a graft were classified as ‘clinically healed’ by visual inspection within a maximum of 5 weeks. With conventional management, closure required a period of several months in three out of four cases. After covering the ulcer with Apligraf ® , the skin reconditioned, resulting in fair skin color and a smooth skin surface in all but one case. HR‐US images, however, revealed large subepidermal deficits of elastic and collagenous fibers at the time of ‘clinical healing’ in 14/18 engrafted ulcers, findings that are strongly indicative of a weakened skin scaffolding. Conclusion: We suggest that the healing process for chronic ulcers can be monitored with both standard visual inspection (photography) and HR‐US to allow early intervention.