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J Acupunct Res > Volume 32(3); 2015 > Article
Jo, Lee, Hong, and Kang: Two Cases of Pressure Ulcer Patients Treated with Acupuncture and Light Emitting Diode Light Therapy

Abstract

Objectives:

We report two cases of pressure ulcer patients to show the efficacy of treatment with acupuncture and Light Enitting Diode(LED) light therapy.

Methods:

We treated two pressure ulcer patients with acupuncture, LED light therapy, herbal medication and with a simple dressing. LED light with up to 4J/cm2 of energy irradiated the pressure ulcer site once a day for fifteen minutes. All patients received acupuncture treatment and simple dressing for wound care. We measured phase change of the pressure ulcer in terms of ulcer size, The National Pressure Ulcer Advisory Panel(NPUAP) stage and with the The Pressure Ulcer Scale for Healing(PUSH) tool(3.0).

Results & Conclusions:

In each of the two cases, pressure ulcer size and total score of the PUSH tool decreased and NPUAP stage was improved from II to I. This shows that acupuncture treatment and LED light therapy may have a considerable effect in healing on the pressure ulcer.

Fig. 1
Changing ulcer size and phase of case 1
acupunct-32-3-211f1.gif
Fig. 2
Changing ulcer size and phase of case 2
acupunct-32-3-211f2.gif
Table 1
NPUAP Pressure Ulcer Stages/Categories(2007)
Non-blanchable erythema
Category/stage I   · Intact skin with non-blanchable redness of a localized area usually over a bony prominence.
  · Painful, firm, soft, warmer or cooler as compared to adjacent tissue.

Partial thickness
Category/stage II   · Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough.
  · An intact or open/ruptured serum-filled or sero-sanginous filled blister.
  · shiny or dry shallow ulcer without slough or bruising*.

Full thickness skin loss
Category/stage III   · Full thickness tissue loss.
  · Subcutaneous fat may be visible but bone, tendon or muscle are not exposed.
  · Slough may be present but does not obscure the depth of tissue loss.
  · May include undermining and tunneling.

Full thickness tissue loss
Category/stage IV   · Full thickness tissue loss with exposed bone, tendon or muscle.
  · Slough or eschar may be present.
  · Often includes undermining and tunneling.

* bruising indicates deep tissue injury.

Table 2
Pressure Ulcer Scale for Healing(PUSH) Tool 3.0
Length × width (cm2) 0 1 2 3 4 5
0 0~0.2 0.3~0.6 0.7~1.0 1.1~2.0 2.1~3.0

6 7 8 9 10
3.1~4.0 4.1~8.0 8.1~12.0 12.1~24.0 >24.0

Exudate amount 0 1 2 3
None Light Moderate Heavy

Tissue type 0 1 2 3 4
Closed Epithelial tissue Granulation tissue Slough Necrotic tissue

Total score
Table 3
Changing ulcer size, NPUAP stage and PUSH tool score of case1
Size (mm2) NPUAP stage PUSH tool score
Length×width Exudate amount Tissue type Total score
The 1st day 60×99=5,940 II 10 1 2 13
The 4th day 60×80=4,800 II 10 1 2 13
The 7th day 60×78=4,680 II 10 1 2 13
The 10th day 59×76=4,484 II 10 1 2 13
The 13th day 52×75=3,900 I 10 0 1 11
The 17th day 52×75=3,900 I 10 0 1 11
Table 4
Changing ulcer size, NPUAP stage and PUSH tool score of case2
Size (mm2) NPUAP stage PUSH tool score
Length×width Exudate amount Tissue type Total score
The 1st day 18.5×13=234 II 5 1 2 8
The 3th day 8×4=32 II 1 1 2 4
The 5th day 7×3=21 I 1 0 1 2
The 6th day 4.5×3=13.5 I 1 0 1 2
IV.
IV.

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