4 weeks and no clinical improvement after using the clinic’s standard care for healing during a 2-week period. 39. High frequency sound with a frequency over 16 kHz can hardly be heard, but it is not completely inaudible. Surg Technol Int. Unlike its low frequency precursor, micro-ultrasound struggles with the phenomena of signal loss deep in the anterior, especially with larger prostates. 12. Searchable area is determined by the frequency of the ultrasound used. Use of noncontact low-frequency ultrasound in the treatment of Dolphin echolocation is similar to ultrasound. Initial wound measurements were 9.60 cm2 (SD 5.54), 9.86 cm2 (SD 3.95), and 10.01 cm2 (SD 4.58) for the standard treatment, HFU, and NCLFU groups, respectively; after 4 months, measurements were 4.28 cm2 (SD 2.80), 3.23 cm2 (SD 2.39), and 2.72 cm2 (SD 2.16), a statically significant difference (P = 0.04). Audible sound has a frequency less than 20kHz. Hard ultrasound vs. soft ultrasound Mira-Teeth uses soft ultrasound to deep clean teeth & gums hard ultrasound = low frequency and high power used for destruction of tartar/calculus in dental practices soft ultrasound = high frequency at very low power used in the case of Mira-Teeth 2007;13(6):258–263. Although current results confirm the efficacy of ultrasound in VLU treatment, numerous studies published in recent years reported conflicting results regarding the effectiveness of ultrasound. The high-frequency ultrasound had a significantly higher positive rate of detecting nodules than the low-frequency ultrasound (61.67% vs. 27.31%; χ2=49.96, P<0.01), and the positive rates were positively correlated with liver fibrosis stage (low-frequency: r=0.5437; high-frequency: r=0.3021). 14. Wound-healing outcomes using standardized assessment and care in clinical practice. Although ulcers in the noncontact ultrasound therapy group had a slightly better response to treatment than those in the high-frequency group, the differences were not statistically significant. 11. 2011;128(5):498e–503e. The result is pulses that are spaced far apart- a long wavelength. All types of Doppler ultrasound equipment employ filters to cut out the high amplitude, low-frequency Doppler signals resulting from tissue movement, for instance due to vessel wall motion. Kavros SJ, Miller JL, Hanna SW. A major limitation of this meta-analysis was the lack of pooled comparisons of NCLFU therapy to optimal wound care alone or to an alternative intervention. 28. The transducer head was moved in a slow, controlled manner around the edges of the ulcer in overlapping circles to cover the skin evenly. In: DeLee J, Drez D, Miller MD. Linear (high frequency 7 -15MHz & high resolution but superficial depth 6cm) –for vascular imaging/access, nerve blocks, small parts (e.g. Kavros SJ, Liedl DA, Boon AJ, et al. Ulcers <5 cm2 in area received ultrasound for 5 minutes; ulcers 10 cm2 in area received 10 minutes of ultrasound. Dolphins can produce sound waves with frequencies ranging from 0.25 kHz to 220 kHz, but only those at the upper end of this spectrum are used in echolocation. Vowden KR, Vowden P. Preventing venous ulcer recurrence: a review. But the penetrating ability is also a feature of low frequency waves - the usual telecommunications spectrum. So in terms of aesthetic facial rejuvenation, RF has been around much longer. Driver VR, Yao M, Miller CJ. All groups received standard wound care three times per week for 3 months or until healing. Probes - For distal limb musculoskeletal and ophthalmological purposes – a high frequency linear probe is required; For pelvic and abdominal scanning – a low frequency convex (curvilinear) probe is needed; Reproductive tract – rectal probe (linear) patholytic effect of low dose high frequency US applied on stellate ganglion in two different doses (0 .5 watts/cm 2 vs 3 watts/cm 2, both at 1 MHz frequency) in upper extremity CRPS type I by using SSR for determining the sympathetic effect. 4. de Araujo T, Valencia I, Federman DG, Kirsner RS. It operates at a markedly lower frequency (40 kHz) and was approved for use in the wound care setting by the US Food and Drug Administration (FDA) in 2005 as a Class II device and received marketing clearance (K050129).23 Low-frequency ultrasound has been shown in vitro24 to mainly provide mechanical debridement; in noncomparative clinical outcomes trial,25 low-frequency ultrasound was found to have the potential to improve wound healing via the production, vibration, and movement of micron-sized bubbles in the coupling medium and tissue, which prepares the wound bed for healing by reducing bioburden, enhancing angiogenesis, assisting in debridement of necrotic and devitalized tissues, and stimulating cellular activity.26 According to an in vitro study,27 NCLFU therapy in the initial inflammatory stage also may promote tissue repair, with few adverse effects noted.28. Wound pain decreased significantly in ultrasound-treated groups in comparison with standard treatment alone. 7. Another open-label, nonrandomized, baseline-controlled clinical case series study analysis (N = 51) by Kavros et al36 indicated healing time reductions (9.8 ± 5.5 weeks versus 5.5 ± 2.8 weeks [P <0.0001]) and wound volume percent improvement (37.3% ± 18.6% versus 94.9% ± 9.8% [P <0.0001]) when NCLFU therapy was compared to the clinic’s standard care. Mean time to complete wound healing in the standard treatment, HFU, and NCLFU groups was 8.50 (SD 2.17), 6.86 (SD 2.04), and 6.65 (SD 1.59) months, respectively (P = 0.001; see Table 2) and was statistically significant. Since the ultrasound absorption for water and polymers (PEM consists in aqueous environments generally to >50% out of water due to high hydrophilicity) increases with the square of frequency in the utilized frequency range, high (HFUS) and low (LFUS) frequency ultrasounds are expected to show different interactions with the micro-chambers (MCs). 2008;23(4):178–183. Control data were obtained from a previously published, prospectively collected database from the same clinic. Wound Repair Regen. Venous ulcers: pathophysiology and treatment options. For NCLFU, treatment time per session is dependent on the total ulcer area. However, wounds in the standard treatment group took an average of 2 months longer to heal than those in the ultrasound groups. Kavros SJ, Miller JL, Hanna SW. 15. Use of weekly, low dose, high frequency ultrasound for hard to heal venous leg ulcers: the VenUS III randomised controlled trial. Patients who were eligible to participate were randomized to the standard treatment group, HFU group, or NCLFU group following a centralized randomization schedule using sealed opaque envelopes containing computer-generated random numbers. 25. Speed CA. Thermal agents: cold and heat, ultrasound, and electrical currents. Therefore, higher frequencies are not as penetrating. Ultrasound has a frequency higher than this and in medicine the frequencies range from 1MHz to 15MHz. *Fourth, using ultrasound energy in cosmetic procedures is a relatively new practice. 2011; 342:d1092. Int Wound J. 2008;54(1):57–60. After 2 months, the mean pain score was not significantly different among all groups. High frequency sound is sound of which the frequency lies between 8 and 20 kHz. On the other hand, ultrasound at very high frequencies do not penetrate deeply, but provide acoustic images having very high resolution. Ann Intern Med. These results are supported by other research. Trent JT, Falabella A, Eaglstein WH, Kirsner RS. 32. In a noncomparative study, Ennis et al25 used NCLFU therapy for 8 months to treat 23 patients from a single tertiary-referral, hospital-based wound clinic. 2005;51(8):24–39. 1978;4(4):343–351. Student’s t-test, ANOVA, chi-square, or Fisher’s exact test were used to test for statistical significance in differences between outcomes. However, high-frequency waves are more attenuated than lower frequency waves for a given distance; thus, they are suitable for imaging mainly superficial structures (2-3cm from skin). Stacey MC, Burnand KG, Layer GT, Pattison M, Browse NL. In a randomized, controlled, double-blinded study, Ennis et al34 examined the effectiveness of NCLFU therapy for the healing of recalcitrant diabetic foot ulcers in 55 patients after 12 weeks of care. It is a non-invasive treatment used to lift and tighten loose skin on areas such as the eyebrows, jawline, neck and jowls, as well as improving wrinkles. Blue Cross Blue Shield Association. 2007;20(4):221–226. Searchable area is determined by the frequency of the ultrasound used. Wound treatment option. Ultrasound is short waves with low energy. High frequency sound with a frequency over 16 kHz can hardly be heard, but it is not completely inaudible. Reflected sound waves allow a dolphin to form an image of the object that reflected the waves. Dr. Olyaie is a resident in Radiology, Dr. Rad is an Assistant Professor of Pathology, Dr. Elahifar is an Assistant Professor of Radiology, Dr. Garkaz is a resident in Radiology, and Dr. Mahsa is a cardiologist, Zahedan University of Medical Sciences, Zahedan, Iran. The product’s recommended treatment algorithm is to apply in a manner similar to HFU and is based on longer treatment times for greater total ulcer area. The high-frequency ultrasound had a significantly higher positive rate of detecting nodules than the low-frequency ultrasound (61.67% vs. 27.31%; χ2=49.96, P<0.01), and the positive rates were positively correlated with liver fibrosis stage (low-frequency: r=0.5437; high-frequency: r=0.3021). Ultimately, 90 patients with VLUs (47 men and 43 women, age 38.3 [SD 11.5] years) provided informed consent and participated in the study. Among these are 2 forms of ultrasound treatment: high-frequency (HF) ultrasound and noncontact (NC) low- frequency (LF) ultrasound. 1. 1995;4(2):57–61. 6. Wound Repair Regen. J Am Acad Dermatol. While use of low frequency beams (50 kHz) facilitates a search of wider area, use of high frequency beams (200 kHz) allows the operator to narrow down the search area to detect the more precise location of a fish school. Olyaie M, Rad FS, Elahifar MA, et al. In: Baronski S, Ayello EA, Mclntosh A,Galvan L, Scarborough P. Wound Care Essentials: Practice Principles, 2nd ed. Adv Skin Wound Care. Low Frequency Ultrasound and Noncontact Normothermic Wound Therapy 14. Franco de Oliveira R, Pires Oliveira DA, Soares CP. 2002;166(4):437–441. 36. Background/aims: B-scan ultrasonography is an invaluable, versatile, non-invasive tool in ophthalmology. 8. No previous study compares NCLFU and HFU therapy in VLU treatment. The study protocol at the authors’ facility is to treat wounds up to 4 cm2 with 4 minutes of NCLFU therapy; ulcers 10 cm2 in area received 10 minutes of ultrasound. Cochrane Database Syst Rev. On the other hand, ultrasound at very high frequencies do not penetrate deeply, but provide acoustic images having very high resolution. Abbade LP, Lastória S. Venous ulcer: epidemiology, physiopathology, diagnosis and treatment. Stücker M, Reich S, Robak-Pawelczyk B, Moll C, Rudolph T, Altmeyer PJ, et al. Background/aims: B-scan ultrasonography is an invaluable, versatile, non-invasive tool in ophthalmology. September 28, 2014 at 12:51 pm . 16. The exact frequency of either of those treatments will depend on the type of device used and your skin conditions such as its current elasticity or your genetic heritage. Current management of venous ulcers: an evidence-based review. Clin Dermatol. 2011 Jul-Aug;19(4):475-80. This explains why high frequencies are used for the superficial body structures and low frequencies are used for those that are deeper. High-frequency ultrasound is defined by the production of many waves per unit time, which engage the medium more intensely and return more waves to the probe. Parsa H, Zangivand AA, Hajimaghsoudi L. The effect of pentoxifylline on chronic venous ulcers. 35. Ultrasound at low frequencies such as 10 MHz penetrates deeper into materials than ultrasound at higher frequencies, but the spatial resolution of the acoustic image is less. Dolphin echolocation is similar to ultrasound. This explains why high frequencies are used for the superficial body structures and low frequencies are used for those that are deeper. The following frequencies are a guide to frequencies typically used for ultrasound examination: ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Ostomy Wound Manage. In figure A, a 5 MHz transducer generates ultrasound waves that travel 0.3 mm per cycle (wavelength = 0.3 mm = speed of sound / frequency = 1,540 m/sec divided by 5 x 106 cycles/sec). Herschthal J, Kirsner RS. Potential Conflicts of Interest: none disclosed, Venous leg ulcers (VLUs) are a frequent and persistent challenge in clinical wound care. The device consists of a unit with a transducer, generator, and disposable applicator that uses prepackaged sterile saline. Filter frequency can usually be altered by the user, for example, to exclude frequencies below 50, 100 or 200 Hz. Weekly administration of low dose, high frequency ultrasound therapy (0.5 W/cm(2), 1 MHz, pulsed pattern of 1:4) for up to 12 weeks plus standard care compared with standard care alone. So in terms of aesthetic facial rejuvenation, RF has been around much longer. 37. 2008;35(6):579–583. Int J Dermatol. 2003;138(4):326–334. The small sample size of this study limits ability to draw firm conclusions, especially with respect to potential differences between the two methods of ultrasound therapy, because the difference in healing rates between these groups was smaller than those between standard care and the intervention groups. Brodovicz KG, McNaughton K, Uemura N, Meininger G, Girman CJ, Yale SH. 30. We also investigated the clinical effects of low dose high frequency US in CRPS type I in For example, 30 Hz (low frequency) has a wavelength of 10,000 km (over 6,000 miles) while 300 GHz (high frequency) is just 1 mm. After 4 months of treatment, the average ulcer sizes were 4.28 cm2 (SD 2.80), 3.23 cm2 (SD 2.39), and 2.72 cm2 (SD 2.16) cm2 in the standard, HFU, and NCFLU groups respectively (P = 0.04, see Table 2). Interrelationship between searchable angle and frequency of ultrasound. A significantly higher percentage of patients receiving NCLFU treatment achieved >50% wound healing at 12 weeks than those treated with the standard of care alone (63% versus 29%; P <0.001). As such, the specialized protocol is designed to grade the 70%-80% of cancer that is located in the peripheral zone. Also, after 4 months, investigators recorded progress every month until time of complete wound healing. 3 This neglects the anterior region which accounts for 20%-30% of all prostate cancers. 5. 13. The image on the left was generated with a high frequency (9MHz) linear array transducer, while the image on the right was taken with a low frequency (4MHz) curved array transducer. At the 4 month visit — 1 month after ultrasound treatment was stopped— decreases in ulcer size, edema, and wound pain were all statistically significantly greater in the ultrasound groups than in the control patient group. Margolis DJ, Knauss J, Bilker W. Medical conditions associated with venous leg ulcers. High frequency sound and even ultrasound in the lower frequency zone (up to 24 kHz) can be audible if the sound level is high enough. The mean decrease in pain scores was significantly different after the 4-month visit among the three groups. However, these waves lose energy more rapidly, preventing deep penetration. Wound Repair Regen. 2012;11:CD000265. Ennis WJ, Foremann P, Mozen N, Massey J, Conner-Kerr T, Meneses P. Ultrasound therapy for recalcitrant diabetic foot ulcers: results of a randomized, double-blind, controlled, multicenter study. This randomized clinical trial (RCT) compared healing efficacy and safety of standardized venous ulcer compression with or without HF ultrasound or NCLF ultrasound. Use of weekly, low dose, high frequency ultrasound for hard to heal venous leg ulcers: the VenUS III randomised controlled trial. All wounds were healed after an average of 8.50 (SD 2.17), 6.86 (SD 2.04), and 6.65 (SD 1.59) months in the standard treatment, HFU, and NCLFU groups, respectively (P = 0.001). In a retrospective study, Gehling and Samies37 assessed the pain scores of 15 consecutive patients (seven men, eight women, age range 28–88 years) with painful, nonhealing, lower-extremity wounds treated for 2 to 4 weeks with NCLFU therapy. The results show wound healing was faster in ultrasound groups in comparison with standard treatment alone; ulcer size, mean degree of pain, and edema decreased more in the ultrasound than in the control groups. The study was approved by the ethics committee of the university before its initiation, and the protocols used conformed to the ethical guidelines of the 1975 Helsinki Declaration. 2010;91(5):669–678. Medical ultrasound usually uses frequency ranges between 1 and 20 MHz for imaging purposes and below 2 … The following frequencies are a guide to frequencies typically used for … Standard care dressing changes and ultrasound therapy were provided three times per week for 3 months or until healed. Yao M, Hasturk H, Kantarci A, et al. 24. In: Cameron MH. The searchable range (depth) and search area are dependent upon the frequency used. J Wound Ostomy Continence Nurs. 29. After 3 months, patients continued to be followed until healed. Ostomy Wound Manage. 3. It is a non-invasive treatment used to lift and tighten loose skin on areas such as the eyebrows, jawline, neck and jowls, as well as improving wrinkles. 5. High frequency X-Ray machines use high frequency x-ray generators which are better than conventional single-phase generators due to efficient generation and control of high voltage power required to drive the x-ray tube. Compression bandages are the mainstay and standard treatment for chronic venous ulcers.33 In this study, all wounds eventually healed with the use of compression bandages and standard, nonadherent dressings with or without ultrasound therapy. All data collected were extracted from the patient record and included demographic data; documentation of wound size, pain, and edema; and any side effects of treatment on a regular basis as completed by investigators using a wound data template. 2001;44(3):401–421. CMAJ. Although high-frequency ultrasound (HFU) (1–3 MHz) has been used in clinical practice in most studies and has been shown to promote healing in some injuries,18-21 according to results of randomized, controlled, clinical trials,18,19,22 heat from this electrical devise can cause hot spots, burns, or endothelial injury; as such, use is limited in medical practice. Interrelationship between searchable angle and frequency of ultrasound. For example, gamma waves have high frequency and high penetrating power: intuitively I imagined this as attacking a target rapidly in quick succession and managing to get through. Although this method is scientifically valid and reliable, use of more precise imaging and histopathological assessment methods may have enhanced study accuracy. Explain why high-frequency waves work better than low-frequency waves. Standard care included multilayered compression bandaging (40 mm Hg of pressure at the ankle graduated to 17 mm Hg to 20 mm Hg below the knee), nonadherent dressing, and regular debridement. Pain assessment in cognitively impaired and unimpaired older adults: a comparison of four scales. A high frequency wave with a short pulse length will yield better axial resolution than a low frequency wave. Med Sci Monit. 2001;40(12):1331–1336. Managing the patient with venous ulcers. DeLee & Drez’s Orthopaedic Sports Medicine: Principles and Practice, 2nd ed. 2005;51(5):38–56. Objective. 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