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arterial ulcers, diagnostic ultrasound, low-frequency ultrasound, therapeutic ultrasound, ultrasound therapy, venous ulcers



  1. Kavros, Steven J. DPM, FACCWS, CWS, MAPWCA
  2. Coronado, Robert MD, FACC


GENERAL PURPOSE: To provide information about the use of ultrasound for diagnostic and therapeutic treatment of venous and arterial ulcers.


TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.


LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:


1. Describe the scope of the problem of peripheral vascular disease and the mechanics of ultrasound.


2. Identify research findings related to the diagnostic and therapeutic use of ultrasound for venous and arterial leg ulcers.





To review the diagnostic and therapeutic use of ultrasound on venous and arterial ulcers.


METHODS: PubMed was searched for peer-reviewed articles using the search terms "ultrasound for venous ulcers" and "ultrasound for arterial ulcers." The search yielded 282 articles on ultrasound for venous ulcers and 455 articles for ultrasound on arterial ulcers. Data from 36 articles were selected and included after abstract review.


RESULTS: Ultrasound is an established diagnostic modality for venous and arterial disease and is indicated for wound debridement. Recent evidence continues to support its superiority over standard of care in healing venous ulcers, but findings conflict in terms of the effectiveness of low-frequency ultrasound over high-frequency ultrasound. There are currently no standardized treatment protocols for ultrasound.


CONCLUSIONS: Diagnostic ultrasound is used to assess venous and arterial disease and guide appropriate treatment for ulcers. Therapeutic low-frequency ultrasound is used to debride the wound bed, as an adjunctive topical wound treatment with standard of care, and to guide the application of other advanced therapies to chronic wounds. Better trial designs and consistent data are needed to support the effectiveness of ultrasound therapy on venous and arterial ulcers.