Early Detection of Pressure Ulcers
and Management of Chronic Wounds
Pressure ulcers are a common problem where patients are compromised because of immobility, nutrition, incontinence, or age.
Scan for pressure ulcer
Problems may be developing before patient admission
Where patients have had long operations they may already be developing a pressure ulcer before admission to a care facility and yet the care facility has to deal with the outcome and shoulder responsibility.
Heel scan shows pressure ulcer developing
By having advanced knowledge at the time of admission that a pressure ulcer is forming, the caregiver can take steps to prevent its development and protect itself from any claims that the ulcer arose due to inadequate care
Visualisation of tissue beneath the wound
Until now the caregiver could only visually assess the surface of a wound EpiscanŽ allows the user to look at tissue beneath the wound to see what is occurring. It can aid treatment decisions by helping to determine how deep the wound penetrates and the quality of the tissue beneath the wound.
Even where relief measures are taken and the wound appears to be healing it is all too common for it to erupt anew when special precautions are withdrawn, due to undermining of adjacent, apparently healthy skin which is invisible to the naked eye.
EpiscanŽ can visualise sinus tracts which may necessitate more aggressive debridement and exploration. This may also alert the healthcare provider to the possibility of ostoemyelitis which may warrant further diagnostic testing.
Visualisation of sinus tract formation
Pressure ulcers can be seen to originate deep within the dermis and to propogate outwards towards the surface whilst friction ulcers are seen to be confined to superficial areas.
Visualisation of sub-wound oedema
Friction ulcer and pressure ulcer compared.
The sequence of images on the left shows the healing of a chronic wound. Progress is clearly demonstrated and the images can be displayed in a variety of colour or monochrome options.
It is important to document wound appearance, treatment and outcome for continuity of care and positive clinical outcome. EpiscanŽ is therefore an excellent tool for assessment of wounds, guiding their management and for record keeping.
For pressure sore detection EpiscanŽ uses a hand-held probe with centre frequency 18MHz and there are also two other probes available with centre frequencies of 35MHz and 45MHz. These give greater definition but with shallower penetration and are ideal for dermatologists, skin cancer and burns specialists, plastic and reconstructive surgery and for aesthetic and cosmetic research purposes.
The three probes are easily interchangeable without rebooting the system so the user can simply select whichever is most suitable for the current purpose. Details can be found on other pages of this website, according to the specialist areas concerned.
It is also possible to display linear and area measurements of selected features.
Many wound care experts and researchers believe that oedema under a wound is a prime reason for slow healing. A variety of treatments are aimed at reducing this oedema and EpiscanŽ is the perfect tool to monitor the effectiveness of these.
EpiscanŽ also shows clearly the difference between friction ulcer (left) and a pressure ulcer (right).
EpiscanŽ allows the user to image the peri-wound area to see if undermining is occurring. The treatment regime can then be changed, e.g. to require more aggressive debridement or packing of the wound to prevent new eruptions.
Sinus tract formation is common in wounds. In fact since we can see with ultrasound that most wounds begin deep and then tunnel to the surface, it would be expected that many such wounds have deep sinus tracts.
When they do arise, pressure ulcers are very painful and can be costly and time consuming to treat. Prevention measures such as pressure relief aids, specialised beds and mattresses are expensive and cannot be used for every patient, so targeting these measures is a more cost effective way to manage the problem
The EpiscanŽ dermal ultrasound scanner is ideal for use within both acute and long term care facilities, where it can assist with the early detection and prevention of pressure ulcers and the management of chronic wounds generally.
In the US alone, each year acute-care hospitals treat about 2.5 million pressure ulcers (Institute for Healthcare Improvement).
Pressure ulcers - the cost and how to prevent them
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Estimates for the cost of treating all pressure ulcers range anywhere from US$1.3 - 11 billion (Wall Street Journal).
Whilst in theory pressure ulcers are preventable through correct management of patients, in practice they are all too prevalent. Because they are invisible in the early stages, the damage is done before anyone realises.
It is easy to use at the bedside and chosen scans can be saved at the click of a mouse.
Click picture to enlarge.
In increasingly litigious times a well-documented record of patient care can provide real protection against potential claims.
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PPM Consult Ltd. is a marketing company and we rely upon Manufacturers' representations as to quality and efficacy of products, which are sold directly by them or their apponted agent.
We do not guarantee that goods will be suitable or effective for all purchasers and we recommend that customers seek qualified medical advice before commencing treatment.