Registered Nurses' Association of Ontario

Types of Adjunctive Therapies

Electromagnetic Therapy

  • Electromagnetic therapy (EMT) refers to devices that induce an electric field within tissue through a single coiled electrode that does not need to be applied directly to the tissue (i.e., it can be placed on top of the dressing).
  • At the time of writing, no significant adverse events have been documented with respect to the use of EMT as an adjunctive therapy for the treatment of pressure injuries.
  •  EMT is contraindicated in people:
    • with electrical device implants (e.g., pacemakers)
    • with an organ transplant
    • who are pregnant
    • active bleeding
    • active deep vein thrombosis
    • suspected or confirmed cancer


  • Ultrasound (US) is a form of vibratory or mechanical stimulus that oscillates at a frequency too high to be detected by the human ear.
  • Ultrasound treatment can be applied to open wounds using contact and non-contact technologies.
  • US is contraindicated in people:
    • with uncontrolled bleeding tissue
    • untreated hemorrhagic disorders
    • areas of suspected or known malignancy
    • active deep vein thrombosis (DVT) causing clot
    • recently radiated tissues or ectopic bone formation (e.g., myositis ossifi cans)
    • tissues with encapsulated or virulent infection (e.g., tuberculosis)

Ultraviolet Light

  • Ultraviolet light has wavelengths that are shorter than those in the light that is visible to humans.
  • The NPUAP, EPUAP, & PPPIA guideline recommends only the short-term application of UVC, if other traditional therapies fail.

Laser Therapy is Not Recommended

  • Currently, there is limited evidence on the efficacy of laser therapy as a pressure injury treatment.
  • Moreover, the results are mixed, it is unclear what type of laser should be used, and a potential for harm to or contamination of the person’s pressure injury exists if an inexperienced health-care professional performs the therapy.
  • Other reputable guidelines do not support the routine use of laser therapy at this time.
Clinical Management
Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition
Point of Care Resources