
TECNOLOGÍA ULTRAMIST®
La terapia del sistema UltraMIST® desarrollada para el cuidado de heridas basado en evidencia, Perfecto para Múltiple Estética Aplicación s
Se ha demostrado que la terapia de ultrasonido sin contacto y de baja frecuencia acelera la curación

Se ha demostrado clínicamente que la Terapia UltraMIST aprobada por la FDA promueve la curación en una amplia gama de heridas crónicas y agudas. Esto es lo que hace que UltraMist sea perfecto para múltiples aplicaciones estéticas. El sistema UltraMIST envía ultrasonidos de baja frecuencia al sitio de tratamiento sin tocar la piel usando un líquido (como solución salina) en un aplicador especialmente diseñado que produce una niebla generada por ultrasonidos de baja energía.
Este sistema UltraMist basado en tecnología de ultrasonido acelera la curación mediante la limpieza y el desbridamiento de mantenimiento mediante la eliminación de fibrina, esfacelo amarillo, exudados tisulares y bacterias mientras promueve la producción de colágeno al comprimir y estirar las membranas celulares. UltraMist también promueve la regeneración y vasodilatación aumentando el oxígeno a las células estimulando las áreas dañadas y creando angiogénesis.
El ultrasonido pulsado de baja intensidad acelera los macrófagos que liberan factores de crecimiento, incluidos VegF y PGDF o factores de crecimiento derivados de plaquetas. VegF es esencial para un flujo sanguíneo saludable y la regulación de nutrientes en la piel y los folículos pilosos. Similar al PRP pero "sin agujas dolorosas", el PGDF o los factores de crecimiento derivados de las plaquetas mejoran la eliminación del tejido dañado al aumentar el recuento de neutrófilos. Los neutrófilos eliminan los patógenos bacterianos y fúngicos mediante un proceso conocido como fagocitosis.
UltraMist también lisa la pared celular bacteriana en las superficies de la piel, lo que reduce las bacterias que pueden interferir con el proceso de curación.
Administrada por personal sanitario capacitado a miles de pacientes durante más de una década y respaldada por una amplia gama de evidencia clínica, la terapia de ultrasonido del sistema UltraMIST promueve la curación al controlar la inflamación y reducir las bacterias al tiempo que aumenta la angiogénesis. Además, para promover la curación, aumenta la perfusión a través de la vasodilatación, lo que finalmente aumenta el oxígeno y los nutrientes al tejido.

Cómo funciona UltraMIST
En acción, el sistema UltraMIST elimina mecánicamente las barreras y promueve la cicatrización en una amplia gama de tipos de heridas. Las indicaciones incluyen, entre otras, úlceras del pie diabético, úlceras venosas en las piernas, úlceras por presión y lesiones quirúrgicas, por quemaduras y de tejidos profundos. También reduce y elimina una amplia gama de bacterias, incluidas las biopelículas, al tiempo que conserva las estructuras saludables.

Beneficios clave de la terapia UltraMIST
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Increased Perfusion and Arteriogenesis Aid HealingPACE® treatment leads to an increase in blood perfusion. As the PACE® shockwaves penetrate the microcirculatory system, there is an immediate change in local blood flow in the treated area. Li et al. determined that local blood perfusion increased from two to eight hours after treatment due to the vasodilation (increasing diameter) of preexisting vessels.1 Research performed at the Cleveland Clinic using Doppler readings to measure blood flow in treated tissue showed an increase in blood perfusion and vessel density 24 hours after treatment.2 This increase in perfusion is important since ischemia is often associated with impaired healing.3
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Bacterial Biofilms Disruption Allows Antibiotics to PenetrateAntibiotic-resistant bacterial colonies often produce biofilms. A biofilm is a defense mechanism that creates a physical protective barrier against antibiotic treatment. Wanner et al. concluded that shockwave treatment can break up physical biofilm barriers and allow antibiotics access to entrenched bacteria so bacterial colonies may be eradicated.4 SANUWAVE® conducted bench testing to assess the effect of shockwaves on Staphylococcus aureus (Gram-positive bacterium) and Pseudomonas aeruginosa (Gram-negative bacterium) biofilms, which showed that shockwaves removed completely the viable bacterial biofilms from the shockwave exposed surfaces.
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Inflammatory Response Leads to Cell ProliferationAn immediate inflammatory response is apparent after PACE® treatment. Researchers at the Cleveland Clinic reported a decrease in rolling and sticking leukocytes (white blood cells) and an increase in transmigrating leukocytes moving through the vessel wall and into the treatment area.5 Increasing leukocyte activation assists in the inflammatory phase of wound healing by triggering the release of pro-angiogenic factors. After shockwave treatment, wounds move much faster through the inflammatory phase6 when compared to the normal inflammatory process.7
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Altered Cytokine and Chemokine Expression Promotes HealingStudies show that the early pro-angiogenic and pro-inflammatory responses to PACE® treatment are accompanied by significantly increased expression of both CD31 and angiogenesis pathway-specific genes, including ELR-CXC chemokines (CXCL1, CXCL2, CXCL5), CC chemokines (CCL2, CCL3, CCL4), cytokines (IL-1B, IL-6, G-CSF, VEGF-A), matrix metalloproteinases (MMP3, MMP9, MMP13), hypoxia-inducible factors (HIF-1a), and vascular remodeling kinase (Mst1) as early as six hours and up to seven days post-treatment.2,6,7 This may be evidence of an immediate and long-term angiogenic effect and of a jump start of inflammatory healing response that moves chronic wounds to a normal healing cascade of events. Further, PACE® treatment significantly decreased neutrophil and macrophage (white blood cell) infiltration into the wound, attenuating both CC- and CXC-chemokines at the wound margin.6 This may indicate a change from a chronic, nonhealing wound to a natural healing state. Shockwave treatment was found to decrease the rate of apoptosis (programmed cell death) to normal levels. Wang et al. reported a statistically significant decrease in TUNEL (indicator of apoptosis) after PACE treatment.8
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Mechanical Forces Upregulate Growth FactorsAt a cellular level, PACE® treatment applies mechanical forces to individual cells in the treated tissue. The cells respond to these mechanical forces through cellular expression: Pro-angiogenic and cellular proliferation factors such as endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor (VEGF), von Willebrand factor (vWF), proliferating cell nuclear antigen (PCNA), epidermal growth factors (EGF), and others are upregulated. These factors start a cascade of cellular activities that cause an increase in cellular proliferation and tissue regeneration and have been shown to persist for up to 12 weeks.9
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Outperforms Topical Vascular Endothelial Growth Factor (VEGF) in AngiogenesisThe pro-angiogenic factors released in response to PACE® treatment lead to new blood vessel formation resulting in the creation of new capillary networks in the treated tissue. Vascular endothelial growth factor (VEGF) is related to the growth of new blood vessels that allow prefusion improvement in a wound and periwound region. Wang et al. reported an increase in VEGF after PACE® treatment.8 Davis et al. reported that by Day 7, shockwave treatment created a greater number of blood vessels versus untreated controls.7 Another series of studies compared the effects of shockwave treatment with a direct gene therapy and VEGF application in ischemic tissue.10-12 The shockwave treatment actually outperformed direct topical VEGF application in these studies.
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Granulation Stimulation Factor IncreasesCellular proliferation is one of the most noticeable stages of wound healing: Cells divide and cover the wound surface to close the wound. This process begins with a granulation tissue phase that builds vascularized tissue in the wound defect. Proliferating cell nuclear antigen (PCNA) is a factor related to cellular replication and repair machinery indicating that this stage of wound healing is progressing. Wang et al. reported a statistically significant increase in average PCNA levels after PACE treatment.8 This finding indicates that PACE treatment may accelerate wound granulation. Stojadinovic et al. reported marked granulation tissue development on post-treatment Day 4.7 Saggini et al. reported that the percent of granulation tissue increased significantly in the wounds of patients after being treated with shockwaves. 13
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Wound Closure and Re-Epithelialization AccelerateResults of a recent Phase III clinical trial strongly suggest that the dermaPACE® System has an effect in the stabilization, size reduction and, with time, complete re-epithelialization of chronic wounds, specifically diabetic foot ulcers. Clinically significant re-epithelialization of greater than 90% was demonstrated to have statistical significance at 12 weeks in favor of PACE®-treated wounds (51/107, 47.7%) compared with sham-control wounds (31/99, 31%) (p=0.016). Furthermore, of the wounds that achieved at least 90% wound area reduction at 12 weeks, the median reduction in area exceeded 99%. Overall, PACE-treated wounds were twice as likely to achieve 90% to 100% wound closure compared with sham-control subjects within 12 weeks of the initial PACE procedure. Further, by 12 weeks, the reduction in target ulcer area in PACE subjects was on average 48.6% compared with an average of only 10.7% in subjects randomized to sham-control (p=0.015).14
Referencias
Kavros SJ, Schenck EC. Uso de ultrasonido de baja frecuencia sin contacto en el tratamiento de ulceraciones crónicas de pie y pierna: análisis de 51 pacientes. J Am Podiatr Med Assoc. 2007; 97 (2): 95-101.
Serena T, Lee SK, Lam K, Attar P, Meneses P, Ennis W. El impacto de la ecografía sin contacto, no térmica y de baja frecuencia en los recuentos bacterianos en heridas experimentales y crónicas. Manejo de heridas de ostomía. 2009; 55 (1): 22-30.
Kavros SJ, Wagner SA, Wennberg PW, Cockerill FR. El efecto de la tecnología de transferencia de niebla por ultrasonidos sobre patógenos bacterianos virulentos de heridas. Abstracto. Presentado en SAWC 2002.
Seth AK, Mustoe TA, Galiano et al. La ecografía sin contacto y de baja frecuencia como terapia eficaz contra las heridas de biopelícula infectadas por Pseudomonas aeruginosa. Regeneración de reparación de heridas. 2013; 21 (2): 266-274.
Liedl DA, Kavros SJ. El efecto de la tecnología de transporte de ultrasonidos de niebla sobre el flujo sanguíneo microcirculatorio cutáneo. Abstracto. SAWC, 2001.
Honaker J, Forston M. Uso complementario de la ecografía de baja frecuencia sin contacto para el tratamiento de la sospecha de lesión del tejido profundo: una serie de casos. Enfermeras de continencia de ostomía de heridas J. 2011; 38 (4): 394-403.
Honaker JS, Forston MR, Davis EA, Wiesner MM, Morgan JA. Efectos de la ecografía de baja frecuencia sin contacto sobre la curación de la sospecha de lesión de tejido profundo: un análisis retrospectivo. Int Wound J. 2013; 10 (1): 65-72.
Thawer HA, Houghton PE. Efectos del ultrasonido administrado a través de una niebla de solución salina a heridas en ratones con diabetes mellitus. J Cuidado de heridas. 2004; 13 (5): 1-6.
Yao M, Hasturk H, Kantarci A y col. Un estudio piloto que evalúa la ecografía de baja frecuencia sin contacto y el mecanismo molecular subyacente en las úlceras del pie diabético. Int Wound J. 2014; 11 (6): 586-593.