Subsequent sessions are at this level. The treatment frequency gradually can be reduced from daily to every other day, and finally to twice per week. This type of physical therapy often can be reduced in frequency or intensity as the course of therapy progresses. When the therapist is considering treatment for a superficial wound, the use of ultrasound is contraindicated during the first week of the healing process. On the other hand, ultrasound begun during the second week of repair, when collagen formation and fibroblastic infiltration have begun, can be beneficial.
Fibroblasts respond to therapeutic ultrasound with an enhanced rate of protein synthesis.
When treating an open wound,the therapist must give special consideration to avoid contaminating the wound bed. The wound must be thoroughly cleaned before and after ultrasound treatments. It is important to cleanse the wound with materials that are not destructive to the delicate healing in the wound bed. Pure saline works well for flushing the wound site. The use of agents such as bleach, peroxide, alcohol, caustic chemicals, or full strength betadine should be strictly avoided in wounds.