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Therapeutic Ultrasound - safe for skin graft/flap reconstruction following RTA/bone graft?

Good morning all,

I just wanted to check that therapeutic u/s is not contra-indicated for patients following a skin graft and flap reconstruction? I have a patient that I feel would benefit from a point of view of scarring.

Many thanks

Jane Haynes

7 months ago

Back to General Electrotherapy

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Jane.Haynes127
Jane.Haynes127

Many thanks for your reply Dr Rennie.

Dr Sandy Rennie
Dr Sandy Rennie

In the 2010 (Vol 62, no. 10) Special Issue of Physiotherapy Canada on Electrophysical Agents: Contraindications and Precautions, the authors (Houghton, Nussbaum & Hoens) stated that "Damaged or At Risk" skin conditions could be treated with precaution using continuous or pulsed ultrasound.

Jane.Haynes127
Jane.Haynes127

Thank you very much Tim, much appreciated.

Prof Tim Watson
Prof Tim Watson

Certainly based on the current guidance in the UK the use of Ultrasound would not be contraindicated with skin grafts or flaps (assuming you can take care of infection control issues). I have checked the database and have a fair number of papers for both grafts and flaps, but these are clearly dominated by lab / animal research rather than real world clinical studies.

That having been said, none of those that I have just checked demonstrated adverse outcome or detrimental effect. Will paste a couple of most obvious refs below in case they help:

Albuquerque, F. L., et al. (2016). "Low-intensity pulsed ultrasound stimulation in different regions in the viability of myocutaneous flaps." Journal of Therapeutic Ultrasound 4(1): 25.

Tacani, P. M., et al. (2010). "Mechanical stimulation improves survival in random-pattern skin flaps in rats." Ultrasound Med Biol 36(12): 2048-2056.

Emsen, I. M. (2007). "The effect of ultrasound on flap survival: an experimental study in rats." Burns 33(3): 369-371.

da Costa Goncalves, A., et al. (2007). "Can therapeutic ultrasound influence the integration of skin grafts?" Ultrasound Med Biol 33(9): 1406-1412.

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