ULTRASONIC ASSISTED WOUND DEBRIDEMENT – AN AUSTRALIAN EXPERIENCE Gillian Butcher1, Theresa Swanson2, Loreto Pinnuck1, Meagan Shannon3 1Southern Health (Melbourne, Australia); 2South West Healthcare (Warrnambool, Australia); 3Peninsula Health (Melbourne, Australia).

1. Email: gillian.butcher@southernhealth.org.au
Ultrasonic Assisted Wound Debridement: An
Australian Experience
Gillian Butcher1,Theresa Swanson2, Loreto Pinnuck1, Meagan Shannon3
1.Monash Health, Melbourne Australia
2.South West Healthcare, Warrnambool Australia 3.Peninsula Health, Melbourne Australia
MonashHealth

2. Background and Aim
• 4 public hospitals' in Victoria
Australia
• Funded by Department of
Health New Technology
program
• The aim of trial was to
implement Ultrasonic Assisted
Wound Debridement (UAWD),
into different clinical
environments with different
wound types

3. Method
• A central minimum data set
(CMDS)
• Policies, procedures and
patient education material
• Quarterly meetings of all sites
with the Dept of Health to
review cost, issues and activity
• A train-the-trainer model to
ensure the ongoing availability
of suitably trained staff.
This trial focussed on four types
of wounds:
• Diabetic Foot ulcers
• Chronic leg ulcers
• Pressure ulcers/injuries
• Dehisced surgical wounds

4. Results :
29%
47%
12%
12%
Types of wounds treated
DFUs
Chronic leg ulcers
Pressure injury/ulcer
Dihisced surgical
wounds
• The total number of treatments was 1056 on 223 patients:
• Average number of treatments per patient = 4.7
• 50% of wounds had greater than 75% of wound bed slough
removed with this therapy at each debridement
• While data is still being analysed for percentage of healing,
• one site has shown 60.32% reduction in size of leg ulcers
and
• 36% reduction in size of diabetic foot ulcers over the
course of treatment.

5. Clinical outcomes
Decreased hospital admissions due to:
• Effective debridement in an
outpatient setting and for patients
not suitable for theatre
• Improved, rapid and safe
debridement of wet slough
• Bioburden reduction and
antibacterial activity improved
• Decreased infection rates –
only one patient was admitted to
hospital for a wound infection

6. Clinical outcomes
Cost effectiveness:
• UAWD can be performed in an outpatient
or inpatient setting.
• The total cost of a UAWD treatment was
calculated at $180AUD (including staff
time and all consumables) compared with:
• Simple theatre debridement $3500 AUD
• Average inpatient bed day $800AUD
• One patient had 32 hospital admissions
from 2006-2010 for wound management.
After commencing on UAWD therapy in
January 2011 he had no admissions that
year due to weekly treatments
Ease of use:
• Training is simple and straightforward
and the train-the-trainer model ensures a
continuous skilled workforce.
• All staff trained found the Sonoca 185
easy to use
Pain:
• Not painless as suggested by the
literature
• Topical analgesic applied to the wound at
least 30 minutes prior to UAWD
• 7.9% of participants discontinued
treatment due to pain issues.

7. Case Studies:1, – Dehisced surgical wound and
decreased bioburden
Morbidly obese 60 year old female:
• Dehisced abdominal wound following bowel
surgery.
• UAWD performed at 60% amplitude for 30
minutes
• After one treatment this wound was ready
for Negative Pressure Wound Therapy
(NPWT)
• While the patient was on NWPT the wound
developed pseudomonas aeruginosa
• UAWD in contact mode was used
consecutively for 3 days. At this time
pathology testing showed the wound to be
pseudomonas free.

8. Case Study 2 – Non-healing donor site
Three months post-Coronary Artery Bypass
Graft this graft donor site had not healed
and was infected with Staphylococcus
Aureus:
• The base of the wound had 90% slough and
10% granulation tissue
• Systemic antibiotics were implemented
• LFUD was used in contact mode at 60%
amplitude for 20 minutes, followed by
moist wound dressings
• The following day the wound remained
slough free and Negative Pressure Wound
Therapy was applied
• The wound healed within 4 months.
• No theatre debridement was necessary

9. Conclusions:
• Safe and effective
• Selective debridement
• Antibacterial activity
• Wound stimulation effects
• Sustainable ongoing treatment
modality
Further investigations:
A randomized control trial currently
being conducted at Monash Health
comparing UAWD to conservative
sharps debridement will hopefully
provide us with a better comparison of
healing rates.

10. References
Butcher G, Pinnuck L. Wound Bed Preparation - ultrasonic-assisted
debridement. British Journal of Nursing, 2013 (Tissue Viability
Supplement), Vol 22, No 6
Shannon MK, Williams A & Bloomer M. Low-frequency ultrasound
debridement (Sonoca-185) in acute wound management: A case study.
Wound Practice & Research 2012 Vol 20 Issue 4
Michailidis L, Low Frequency Ultrasonic Debridement: A case of healing
against all odds. Connective Issues, Vol 15 Issue 1 2012