Authors (including presenting author) :
LAM KKA, WAN YT, CHAN HY, HUNG SY, CHEUNG PH, CHEUNG YHK, WONG MYM
Affiliation :
Department of Family Medicine and Primary Health Care, Hong Kong East Cluster, Hospital Authority
Introduction :
Wound management decisions are mostly based on visual observations to assess the wound bed tissue or used photo to record the progress of wound healing. However, some problematic wound like wound with undermining, tract, sinus or pocketing with small opening which are difficult to assess the condition, volume or configuration.
Ultrasound is now widely used in health care. Portable ultrasound is suitable for clinic to assess wound condition which had undermining or unknown condition under skin. Since Oct 2021, portable ultrasound was firstly introduced in Primary Health Care Wound Clinic in Hong Kong East Cluster (HKEC).
Objectives :
To indicate the abnormalities of tissue plain under skin and promote wound healing.
Methodology :
The case studies were conducted in 2 Wound Clinics HKEC. Those cases had undermining wound were invited to have portable ultrasound imaging in the bedside of Wound Clinic. The wound opening was covered by transparency dressing. Portable ultrasound device was connected to iPad for imaging.
A female case presented with umbilicus abscess, the wound with pin-hole opening and mild erythema. Ultrasound shown 3cm deep undermining with tissue defect under skin.
Another female case presented left breast wound, 1.5cm wound opening on the base of left breast with unknown depth of track on 12H. Ultrasound shown around 7cm deep straight tract without branching.
An old lady with right hip abscess wound, on and off with fluid collection detected. Try using suction tubing to assess the depth but coiled inside. After ultrasound imaging, around 3cm tract with 2.2cm x 0.8cm dome shape under skin and form a mushroom like undermining.
Result & Outcome :
After Ultrasound imaging, proper packing and drainage could be performed for unvisualized wound. In order to eliminate pre-mature healing and fluid collection aiming to promote wound healing gradually and prevent further complication. Ultrasound is an effective tool for the assessment of tissue damage. It not only could detect the absence of deep tissue defect, but also offers a potential solution to address the limitation. It can provide accurate and meaningful information to assist in clinical decision making. Future studies should be conducted to enlarge the data base and consider as a routine incorporation of ultrasound in wound assessment to improves patient outcomes.
