1. Applications of Noncontact low frequency ultrasound (NLFU) in wounds treatment
By: Amir (Mansour) zahedi
Supper visor: dr. Ali Yadollahpour

2. Physical therapy procedures for the treatment of wounds
introduction
Electrical fields
Electrical fields
Magneto Therapy
Magneto Therapy
Leaser Therapy
Leaser Therapy
Electromagnetic fields
Ultrasound Therapy

3. WHAT IS ULTRASOUND?
Ultrasound is a sound wave that has a frequency greater than 20 KHz.
It is generated by applying an alternate current to a piezoelectric
Crystal (found in the transducer in the sound head). This crystal
contracts and expands at the same frequency at which current changes
polarity. The sound field generated by this crystal in turn makes the
molecules in the sound field vibrate and oscillate.
The crystal commonly used in US units is synthetic plumbium
zirconium titanate (PZT).
The quality of the crystal is what makes your US expensive.

4. Type of ultrasound

5. Improving outcomes with noncontact low-frequency ultrasound : A glimpse of NLFU in action for wounds

7. Necrotic tissue present Non-resolving inflammation
cusses for Stalled Wounds
Necrotic tissue present
Non-resolving inflammation
Bacterial contamination or infection
High levels of proteases
Impaired perfusion and decreased tissue oxygenation
Recurrent physical trauma
Systemic problems: -Diabetes
-Auto-immune disease
-Cancer and cancer treatments
-Other atypical skin disorders

8. Complications of wounds
The most common wound complications are:
Infections: Wound infection presents with pus drainage, foul odor, fever, dull throbbing pain, mild swelling and heat at wound site.
Inflammation: Inflamed wounds are hot, red, painful, swollen and hard to move.
Scarring: Regenerated cells have different characteristics and fibrous tissue that can heal the wound, but may leave a scar behind.
Loss of function: Many wounds can be disabling and life threatening if a major organ, blood vessel or nerve was damaged. Either way, while the wound is still fresh or healing, the affected limb or area will lose its functionality until all lost or damaged tissue is repaired

9. Low frequency, low intensity ultrasound 40 kHz
NLFU based therapy
Low frequency, low intensity ultrasound
40 kHz
Delivered through saline mist
Non-Thermal
Noncontact/painless delivery

12. Osmotic Activity MECHANISMS OF ACTION
Promotes both autolytic and mechanical debridement
Aids in cleansing, debridement and edema reduction
Constant outflow of fluid helps to mechanically lift necrotic tissue
Lymphatic fluid delivers plasminogen to the wound site helping to break down necrotic tissue through fibrinolysis
Osmotic Activity

13. pH Modulation
Lowering pH decreases protease activity Can help reduce inflammation
Optimizes conditions for fibroblast migration, proliferation, organization of collagen
Increases oxygen diffusion
Can help to overcome oxygen transport issues
Low pH inhibits bacterial growth

14. Penetrates deep into the wound bed and accelerates the body’s normal healing process by:

15. MIST effects a wide range of bacteria , including:
E.coli
S. aureus
MRSA
VRE
Pseudomonas

17. Reducing Inflammation
Deep Tissue Injury (DTI)
A significant factorin tissue damage for DTI is the inflammatory response.
MIST sound waves reduce inflammation deep below the surface to promote healing and reduces tissue loss

19. Phases of Wound Healing
Wound Healing Physiology
Phases of Wound Healing
Hemostasis(0-3 hours)
Inflammatory (0-3 days)
Proliferative (3-21 days)
Remodeling/Maturation (21 days–1.5 yrs)

22. results
The results show that therapeutic ultrasound stimulates the production of angiogenic factors such as IL-8, bFGF and VEGF. This may be one of the mechanisms through which therapeutic ultrasound induces angiogenesis and healing.
Both ultrasound machines produced similar results, and the optimum intensities were 0.1 and 0.4 W/cm2 (SATA)with 1 MHz ultrasound, and 15 and 30 mW/cm2 (SATA)with 45 kHz ultrasound.
More recently, the nonthermal effects of US, which are achieved at intensities of <0.3-1W/cm2,

26. A. Position leading edge of the applicator 0.5-1.5 cm from
the wound bed in a perpendicular fashion.
For best results, the Treatment Wand should be parallel to the floor
B. Press and release the black Control Button to
begin treatment
Green indicator light will flash when ultrasound is being delivered, and 2 short tones will sound
C. Deliver MIST treatment by slowly moving Treatment
Wand in a horizontal and vertical pattern over the wound bed
If treatment needs to be paused, press the black Control Button and turn off saline to avoid dripping. To continue treatment, turn saline on and depress black Control Button

28. Civilization is “civilization” in Espirooz and in the Alp too, the civilization is born only of nation’s cerebrations and its intellectual civilization.
تمدن در اسپیروز(زاگرس) " تمدن" است و در آلپ هم تمدن است،تمدن تنها زاییده ی افکار یک ملت است و آن "تمدن فکری" است.
امیر (منصور) زاهدی
Thank you