High Frequency Ultrasound, its Application in Wound Assessment and Prevention

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Transcript of High Frequency Ultrasound, its Application in Wound Assessment and Prevention

Page 1: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

High Frequency Ultrasound, its Application in Wound Assessment and

Prevention

Page 2: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

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EPISCAN I-200

Page 3: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

The EPISCAN is a high frequency ultrasound scanner that utilises ultrasound in the range 20 to 50MHz to image skin and underlying soft tissue.

The system is portable such that it can be taken to the patients bedside as well as being used in “walk in” clinics

The system has been designed to be user friendly and

includes measurement and images assessment tools.

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EPISCAN - I - 200

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50 MHz Image of Skin

Page 5: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

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Indications for Use

• Skin cancers and other lesion mapping• Wound and scar assessment• Burn assessment • Skin assessment for pressure ulcer detection

and prevention• Monitoring the impact of aesthetic procedures• Assessing the impact of medications on the

skin• Implant assessment• Superficial musculoskeletal diagnosis

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Example Images

Skin Cancer

Musculoskeletal Imaging

Spider Vein

Page 7: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

Approvals and Clearances

Diagnostic ultrasound is a safe and well established imaging modality that remains the preferred imaging tool of clinicians around the world

Longport’s EPISCAN system has gained both European CE and US FDA clearance.

Units are also UL kite marked

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““EPISCAN I-200 high-frequency ultrasound system is a EPISCAN I-200 high-frequency ultrasound system is a specialized system for imaging the skin and underlying soft tissue. specialized system for imaging the skin and underlying soft tissue. It is intended for use by clinicians, or under the direction of It is intended for use by clinicians, or under the direction of physicians for imaging and analysis in research environments as physicians for imaging and analysis in research environments as well as clinical settings including medical / surgical dermatology well as clinical settings including medical / surgical dermatology assessment and diagnosis (aesthetic and therapeutic), plastic / assessment and diagnosis (aesthetic and therapeutic), plastic / reconstructive surgical planning, wound assessment and reconstructive surgical planning, wound assessment and management, skin assessment for pressure ulcer detection and management, skin assessment for pressure ulcer detection and prevention and superficial musculoskeletal diagnosis.”prevention and superficial musculoskeletal diagnosis.”

510K 062671

FDA Clearance

Page 9: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

Wound Prevention and Assessment

One of the main applications of the EPISCAN is the prevention and assessment of wounds.

Intervention based upon the high frequency ultrasound images has been shown to result in the prevention of open wounds and the accelerated healing of existing wounds

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Page 10: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

Early Detection of WoundsNormal and Abnormal Ultrasound Images

of the Heel

Epidermis

Dermis

Subcutaneoustissue

Bone

Normal ultrasound of heel

Epidermis

Dermis

Subcutaneoustissue

Edema

Bone

Abnormal ultrasound of heel

Note increased black areas in the abnormal scan, which represent oedema resulting from the early phase of wound development. No visible sign of breakdown will be evident at the skin surface

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• We conclude that EPISCAN, in extended care rehabilitation units, is a cost-benefit to providers for preventing costly pressure ulcers. The expected cost savings for the at-risk patient is approximately $5,300.00 per resident over a 1 year period. Ron Shannon, quote from poster presented at SAWC April 2007

• Use of ultrasound for early care planning is a new concept but can have a significant impact on clinical management of risk. Karen Zulkowski, quote from poster presented at SAWC April 2007.

…..the scanner’s utility has already been realized through reduced treatment costs the incidence of pressure ulcers at Hawfields had dropped to 2 percent in February 2007, from 7 percent in September 2005, and the nurses’ treatment time has been better utilized in other direct-care patient issues such as teaching, documentation, and assessment-related procedures. Max Kernodle (Longport customer) quote from article in Provider journal, April 2007

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Recent comments on wound prevention from studies conducted with Longport’s technology and from customer

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Wound Assessment

High frequency ultrasound images can provide data on issues such as wound undermining and sinus tracks as well as detect changes to the wound bed.

Unlike visual assessment ultrasound can see deep into the wound providing the clinician with early data on the evolving wound

Ultrasound does not cause damage to the wound

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Punch Biopsy Sequence

Pre-Biopsy After 7 Days

After 14 Days After 21 Days

After 28 Days After 35 Days

After 48 Days

After 63 Days

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1 monthTime 0 2 weeksNormal 2 Months

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Imaging sequence showing the healing of a chronic wound

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Wound Undermining

Undermining

Epidermis

Dermis

Wound

Page 16: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

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Quantitative Images Assessment

In many situation the clinician is looking to determine change that has that occurred as the result of a treatment plan and although the EPISCAN ultrasound images provide a reliable pictorial representation it is often preferred to have numerical data to work with.

Longport has developed software such that quantitative data can be extracted from the images. The approach taken is to analysis the distribution of signal strength used to write each pixel of the image or defined area of the image.

Examples of the data generated are shown in the following slides

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0

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2000

0 20 40 60 80 100

Pre Moisturizer

Moisturizer

1hr After Application

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Distribution of Pixel Intensity for Skin Having Moisturizer Applied

Intensity Level

Num

ber of Pixels

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Comparative Statistical Analysis of the Three Moisture Scans

Pre Moisturizer Moisturizer Applied

1 hr After Application

Median Intensity

40 29 31

Variance 268341.49 341359.49 318341.94

Coefficient of variation (%)

91.63 103.35 99.8

Page 19: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

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% Cumulative Pixel Data

0

20

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60

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113 25 37 49 61 73 85 97

109

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157

169

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193

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217

229

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253

Pixel Intensity

Cum

ulat

ive

%

NormalTime 02 Weeks4 Weeks8 Weeks12 Weeks16 Weeks

Changes to a Wound Bed with Time

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System Specifications

• Various probes at centre frequencies between 16 & 50MHz

• 15mm scan length• Digitalisation rate up to 200 million

samples per second• Wireless and cable net working

capability• CD/DVD Read/Write ROM• Multiple memory card slots• Blue tooth enabled• 17 inch screen (1280 x 1024)• Footswitch option• CE/UL Certified, US FDA Marketing

Clearance obtained

• Windows XP Operating system• Linear & area measurement plus text

annotation functions• Integrated relational database for the

patient / image record retention• Multiple image viewing• Image analysis functions• Multiple image viewing palette options• Image export as DICOM and BMP files• Drag and drop capability into Microsoft

Office programs• Digital photographs can be integrated• User selectable images size up to

1024 x 2048 pixels

Page 21: High Frequency Ultrasound,  its  Application in Wound Assessment and Prevention

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For further information on this system and its applications please contact:

PPM Consult Ltd

Business web site: PPMconsult.com Medical web site: a1med.net

E-mail: [email protected]