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High Resolution Ultrasound High Resolution Ultrasound
Detection, Prevention and Management of Detection, Prevention and Management of Pressure UlcersPressure Ulcers
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EPISCAN I-200EPISCAN I-200
LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC
10% of 10% of of patients in acute and extended of patients in acute and extended stay facilities in the western world develop stay facilities in the western world develop pressure ulcers. pressure ulcers.
Annual cost ~$7billionAnnual cost ~$7billion
IncidenceIncidence
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• Ultrasound Biomicroscopy Ultrasound Biomicroscopy
• Non-invasive visualization of skin and Non-invasive visualization of skin and underlying two centimeters of soft tissue underlying two centimeters of soft tissue
High Frequency UltrasoundHigh Frequency Ultrasound
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Reflections from probe membrane
Coupling gel
Stratum corneum of epidermis
Living strata of epidermis
Reflections from acoustic interfaces(e.g. between collagen & hydrated ground substance) in papillary layer of dermis
Reflections from acoustic interfaces in reticular layer of dermis
Hypodermis (panniculus adiposus)
Reflections from collagen & ground substance interfaces within fibrous supports of adipose tissue
Normal SkinNormal Skin
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The Episcan I-200 utilizes high frequency broadband The Episcan I-200 utilizes high frequency broadband (single pulse) ultrasound and digital technology to image (single pulse) ultrasound and digital technology to image the skin and underlying soft tissue to very high the skin and underlying soft tissue to very high resolution. resolution.
Captured images can be stored on hard disk, backed up Captured images can be stored on hard disk, backed up on an integrated CD writer and electronically transferred on an integrated CD writer and electronically transferred for remote archiving or interpretation. Digital for remote archiving or interpretation. Digital photographs can be integrated into the patient record.photographs can be integrated into the patient record.
The TechnologyThe Technology
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AdvantagesAdvantages
• Objective Assessment forObjective Assessment for Early and reliable detection of developing pressure ulcersEarly and reliable detection of developing pressure ulcers Improved monitoring of existing woundsImproved monitoring of existing wounds Risk-based and cost-effective treatmentsRisk-based and cost-effective treatments
• Objective Documentation forObjective Documentation for Advanced record keepingAdvanced record keeping Improved staff awarenessImproved staff awareness Reduce exposure to litigation and sanctions Reduce exposure to litigation and sanctions
Episcan I-200 Episcan I-200 Ultrasound ScannerUltrasound Scanner
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• Early and reliable detection of developing Early and reliable detection of developing pressure ulcers pressure ulcers
Image tissue changes that precede Image tissue changes that precede visible changes regardless of skin visible changes regardless of skin pigmentationpigmentation
Episcan I-200 Episcan I-200 Ultrasound ScannerUltrasound Scanner
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
PathogenesisPathogenesis
“ “Pressure ulcers appear to begin in the subcutaneous Pressure ulcers appear to begin in the subcutaneous tissue between the skin and bone as pockets of tissue between the skin and bone as pockets of edema, indicated ultrasonically by pockets of weak edema, indicated ultrasonically by pockets of weak reflections and progress by direct extension into reflections and progress by direct extension into dermal tissue”dermal tissue”
Paul Quintavalle, DPMPaul Quintavalle, DPMDirectorDirectorVirtua Wound Care Center Virtua Wound Care Center
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Pre-Pressure Ulcers were induced in healthy volunteers by weighting the Pre-Pressure Ulcers were induced in healthy volunteers by weighting the heels for 1 hour. heels for 1 hour.
Edema was found to begin in the subcutaneous tissueEdema was found to begin in the subcutaneous tissue
45 Minutes after pressure was removed.
Induced Pre-Pressure UlcerInduced Pre-Pressure Ulcer
Normal heel prior to pressure
Note the edema in the Sub-Q tissue
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Phase One Pre-Pressure UlcerPhase One Pre-Pressure Ulcer
Intact EpidermisNormal Dermis
Pockets of subcutaneous inflammation
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Phase Two Pre-Pressure UlcerPhase Two Pre-Pressure Ulcer
Intact Epidermis
Strips of dermal damage
Increased subcutaneous damage
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Phase Three Pre-Pressure UlcerPhase Three Pre-Pressure Ulcer
Intact Epidermis
Strips of dermal damage
Increased subcutaneous damage
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Superficial Edema
Friction
Differentiate pressure ulcer from friction or incontinence related Differentiate pressure ulcer from friction or incontinence related breakdownbreakdown
Deep Edema
Pressure
Epidermis
Dermis
Episcan I-200 Ultrasound ScannerEpiscan I-200 Ultrasound Scanner
LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC
Episcan I-200 Ultrasound ScannerEpiscan I-200 Ultrasound Scanner
Improved monitoring of existing woundsImproved monitoring of existing wounds
“ “ Up until now, nurses have been limited to a two-Up until now, nurses have been limited to a two-dimensional picture and the presence of exudate for dimensional picture and the presence of exudate for assessing a wound. With this scanner we can see if assessing a wound. With this scanner we can see if healing has taken place in deeper tissue and not just on healing has taken place in deeper tissue and not just on the surface. This device takes the guess work out of the surface. This device takes the guess work out of wound treatment.”wound treatment.”
Courtney H. Lyder, NDCourtney H. Lyder, NDProfessor, University of VAProfessor, University of VA
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Episcan I-200 Ultrasound ScannerEpiscan I-200 Ultrasound Scanner
• Improved monitoring of existing woundsImproved monitoring of existing wounds
• Reveals sinus tracks, wound undermining, and Reveals sinus tracks, wound undermining, and edemaedema
LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC
Wound UnderminingWound Undermining
Undermining
Epidermis
Dermis
Wound
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Sinus TractSinus Tract
Epidermis
Sinus track
Dermis
Wound
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Measuring Treatment EffectivenessMeasuring Treatment Effectiveness
Epidermis Fluid
Dermis
left heel (day 1) left heel (day 7)
Same heels compared a few days after heel care program implemented. Notice a dramatic reduction of fluid between epidermis and dermis
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
Episcan I-200Episcan I-200 Ultrasound Scanner Ultrasound Scanner
Implement treatment based on these Implement treatment based on these objective findings!objective findings!
““Facilities’ caregivers now can target the Facilities’ caregivers now can target the intervention much more precisely based on the intervention much more precisely based on the interpretation of the scans.”interpretation of the scans.”
John Hertig, CEOJohn Hertig, CEOAdvanced Clinical ServicesAdvanced Clinical Services
Referenced from “Nursing Homes” magazine May 2004Referenced from “Nursing Homes” magazine May 2004
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Control Resource UtilizationControl Resource Utilization
Risk-based and cost-effective treatmentsRisk-based and cost-effective treatments
““Thank you for the opportunity to become involved with your Thank you for the opportunity to become involved with your High Frequency Ultrasound Technology for soft tissue High Frequency Ultrasound Technology for soft tissue evaluation; we have found numerous benefits since we evaluation; we have found numerous benefits since we purchased your scanner…allows us to maintain a minimum purchased your scanner…allows us to maintain a minimum number of protocols thereby reducing the variety of wound number of protocols thereby reducing the variety of wound management products and associated costs.”management products and associated costs.”
Administrator,Administrator,Little Flower ManorLittle Flower ManorWilkes Barre, PAWilkes Barre, PA
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Implement wound care strategies best suited for Implement wound care strategies best suited for wound characteristics……wound characteristics……
Patient specificPatient specific
Wound specificWound specific
Risk-based and cost-effective treatmentsRisk-based and cost-effective treatments
Resource control utilizationResource control utilization
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
Episcan I-200Episcan I-200 Ultrasound Scanner Ultrasound Scanner
Reduce exposure to litigation and sanctionsReduce exposure to litigation and sanctions
“ “Pressure ulcers are the #1 litigated wound Pressure ulcers are the #1 litigated wound problem in nursing homes and long term problem in nursing homes and long term care.”care.”
Courtney H. Lyder, NDCourtney H. Lyder, ND
Professor, University of VA Professor, University of VA
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
Reduce Exposure to Litigation Reduce Exposure to Litigation and Sanctionsand Sanctions
• Advanced record keepingAdvanced record keeping
• Comprehensive electronic recordComprehensive electronic record
• Integrate patient and wound assessment Integrate patient and wound assessment datadata
• Integrate treatment protocols and ultrasound Integrate treatment protocols and ultrasound imagesimages
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 Resolution Ultrasound for High Resolution Ultrasound for Management of Pressure UlcersManagement of Pressure Ulcers
• Detection of pressure ulcers before clinical signs Detection of pressure ulcers before clinical signs are apparentare apparent
• Documentation of the existence of pressure ulcers Documentation of the existence of pressure ulcers on admissionon admission
• Targeting treatments to specific anatomical areasTargeting treatments to specific anatomical areas• Distinguishing between pressure ulcers and Distinguishing between pressure ulcers and
friction ulcersfriction ulcers• Measuring treatment effectivenessMeasuring treatment effectiveness• Increasing awareness and complianceIncreasing awareness and compliance
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
Episcan I-200Episcan I-200 Ultrasound Scanner Ultrasound Scanner
Conclusion:Conclusion:
• The Episcan I-200 is a valuable tool for The Episcan I-200 is a valuable tool for pressure ulcer detection and assessmentpressure ulcer detection and assessment
• Can aid in the reduction of the incidence of Can aid in the reduction of the incidence of pressure ulcerspressure ulcers
• Can aid in the treatment of pressure ulcersCan aid in the treatment of pressure ulcers
• Can aid in the reduction of liabilityCan aid in the reduction of liability
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
Further Information
For further information on this system and its applications and global sales enquiries please contact:
PPM Consult Ltd
Business web site: PPMconsult.com Medical web site: A1med.net
E-mail: [email protected]