The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding), and by imprecise results (few patients and outcome events).
A Cochrane review [Abstract] 1 included 11 studies with a total of 969 subjects. Nine studies evaluated high frequency ultrasound and 7 of these reported data for ulcers healed and 2 provided data on change in ulcer size only. Two studies evaluated low frequency ultrasound and both reported ulcers healed data.
There was no statistically significant differences in the proportion of ulcers healed between high frequency ultrasound and no ultrasound at any of the time points evaluated: at 7 to 8 weeks (RR 1.21, 95% CI 0.86 to 1.71; 6 studies, n=678); at 12 weeks (RR 1.26, 95% CI 0.92 to 1.73; 3 studies, n=489); and at 12 months (RR 0.93, 95% CI 0.73 to 1.18; 1 study, n=337).One study (n=92) reported that a greater percentage reduction in ulcer area was achieved at 4 weeks with high-frequency ultrasound, while another (n=73) reported no clear difference in change in ulcer size at 7 weeks. Data from one study (n=337) suggested that high frequency ultrasound may increase the risk of non-serious adverse events (RR 1.29, 95% CI 1.02 to 1.64) and serious adverse events (RR 1.21, 95% CI 0.78 to 1.89).Only 1 study reported health-related quality of life and found no association with treatment.
It was uncertain whether low frequency ultrasound affects venous ulcer healing at 8 and 12 weeks (RR 3.91, 95% CI 0.47 to 32.85; 2 studies, n=61). The outcomes of adverse effects, quality of life and cost were not reported for low-frequency ultrasound treatment.
Primary/Secondary Keywords