ultrasound and tissue healing

fins deck

inflammation

vascular cascade

mast cells degranulate inflam mediators

(cytokines and histamine)

vasodilation

increased capillary permeability

cytokines and chemokines release

cellular cascade

neutrophils arrive first causing phagocytosis (engulf unwanted material)

macrophages clean up remaining debris and coordinate repair

ultrasound and inflammation

• watson et al

• increases platelets

• increases mast cells

• increases white blood cells

• acoustic streaming will cause degranulation of mast cells

proliferation

angiogenesis - formation of new blood vessels

improves oxygen and blood supply

fibroplasia

multiplication of fibroblasts

formation of granulation tissue

proliferation ultrasound

stimulates fibroblast activity

increases collagen laydown and synthesis

promotes stronger tissue formation

warden et al found low dose pulsed ultrasound increases fibroplasia and collagen synthesis

remodelling

type 3 - type 1 collagen

fibres start to re align a bit

improves tissue structure

remodelling ultrasound

assists type 3 - type 1

influences fibre orientation

enhances scar tissue mobility

yeung found ultrasond can enhance functional capoacity of scar tissue

cavitation

stable = gas bubbles forming from dissolved gasses

unstable = gas bubbles popping

causes heating and cell death

acoustic streaming

the eddying of fluids in the ultrasound stream

speeds up cavitation

encourages serotonin release from platelets

micro massage

• increases fluid movement in tissue

• helps remove waster

• reduces swelling

• helps break down adhesions

standing waves

when peaks and troths align

produces thermal effects and cell death

thermal effects continuous

increases tissue temperature

improves blood supply

promotes tissue healing