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

• 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.