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High Resolution Ultrasound Detection, Prevention and Management of Pressure Ulcers

LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC. High Resolution Ultrasound

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High Resolution Ultrasound Detection, Prevention and Management of Pressure Ulcers

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  1. LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC High Resolution Ultrasound Detection, Prevention and Management of Pressure Ulcers

  2. EPISCAN I-200 LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  3. Incidence 10% of of patients in acute and extended stay facilities in the western world develop pressure ulcers. Annual cost ~$7billion LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  4. High Frequency Ultrasound • Ultrasound Biomicroscopy • Non-invasive visualization of skin and underlying two centimeters of soft tissue LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  5. Normal Skin Reflections from probe membrane Couplinggel Stratum corneum of epidermis Living strata of epidermis Reflections from acoustic interfaces (e.g. between collagen & hydrated ground substance) in papillary layer of dermis Reflections from acoustic interfaces in reticular layer of dermis Hypodermis (panniculus adiposus) Reflections from collagen & ground substance interfaces within fibrous supports of adipose tissue LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  6. The Technology • The Episcan I-200 utilizes high frequency broadband (single pulse) ultrasound and digital technology to image the skin and underlying soft tissue to very high resolution. • Captured images can be stored on hard disk, backed up on an integrated CD writer and electronically transferred for remote archiving or interpretation. Digital photographs can be integrated into the patient record. LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  7. Episcan I-200 Ultrasound Scanner • Advantages • Objective Assessment for • Early and reliable detection of developing pressure ulcers • Improved monitoring of existing wounds • Risk-based and cost-effective treatments • Objective Documentation for • Advanced record keeping • Improved staff awareness • Reduce exposure to litigation and sanctions LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  8. Episcan I-200 Ultrasound Scanner • Early and reliable detection of developing pressure ulcers • Image tissue changes that precede visible changes regardless of skin pigmentation LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  9. Pathogenesis “Pressure ulcers appear to begin in the subcutaneous tissue between the skin and bone as pockets of edema, indicated ultrasonically by pockets of weak reflections and progress by direct extension into dermal tissue” Paul Quintavalle, DPM Director Virtua Wound Care Center LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  10. Induced Pre-Pressure Ulcer Pre-Pressure Ulcers were induced in healthy volunteers by weighting the heels for 1 hour. Edema was found to begin in the subcutaneous tissue Note the edema in the Sub-Q tissue 45 Minutes after pressure was removed. Normal heel prior to pressure LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  11. Phase One Pre-Pressure Ulcer Intact Epidermis Normal Dermis Pockets of subcutaneous inflammation LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  12. Phase Two Pre-Pressure Ulcer Intact Epidermis Strips of dermal damage Increased subcutaneous damage LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  13. Phase Three Pre-Pressure Ulcer Intact Epidermis Strips of dermal damage Increased subcutaneous damage LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  14. Episcan I-200 Ultrasound Scanner Differentiate pressure ulcer from friction or incontinence related breakdown Epidermis Dermis Deep Edema Pressure Superficial Edema Friction LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  15. Episcan I-200 Ultrasound Scanner Improved monitoring of existing wounds “ Up until now, nurses have been limited to a two-dimensional picture and the presence of exudate for assessing a wound. With this scanner we can see if healing has taken place in deeper tissue and not just on the surface. This device takes the guess work out of wound treatment.” Courtney H. Lyder, ND Professor, University of VA LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  16. Episcan I-200 Ultrasound Scanner • Improved monitoring of existing wounds • Reveals sinus tracks, wound undermining, and edema LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  17. Wound Undermining Wound Epidermis Dermis Undermining LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  18. Sinus Tract Wound Epidermis Dermis Sinus track LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  19. Measuring Treatment Effectiveness left heel (day 1) left heel (day 7) Epidermis Fluid Dermis Same heels compared a few days after heel care program implemented. Notice a dramatic reduction of fluid between epidermis and dermis LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  20. Episcan I-200 Ultrasound Scanner Implement treatment based on these objective findings! “Facilities’ caregivers now can target the intervention much more precisely based on the interpretation of the scans.” John Hertig, CEO Advanced Clinical Services Referenced from “Nursing Homes” magazine May 2004 LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  21. Control Resource Utilization Risk-based and cost-effective treatments “Thank you for the opportunity to become involved with your High Frequency Ultrasound Technology for soft tissue evaluation; we have found numerous benefits since we purchased your scanner…allows us to maintain a minimum number of protocols thereby reducing the variety of wound management products and associated costs.” Administrator, Little Flower Manor Wilkes Barre, PA LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  22. Risk-based and cost-effective treatments Implement wound care strategies best suited for wound characteristics…… Patient specific Wound specific Resource control utilization LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  23. Episcan I-200 Ultrasound Scanner Reduce exposure to litigation and sanctions “Pressure ulcers are the #1 litigated wound problem in nursing homes and long term care.” Courtney H. Lyder, ND Professor, University of VA LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  24. Reduce Exposure to Litigation and Sanctions • Advanced record keeping • Comprehensive electronic record • Integrate patient and wound assessment data • Integrate treatment protocols and ultrasound images LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  25. High Resolution Ultrasound for Management of Pressure Ulcers • Detection of pressure ulcers before clinical signs are apparent • Documentation of the existence of pressure ulcers on admission • Targeting treatments to specific anatomical areas • Distinguishing between pressure ulcers and friction ulcers • Measuring treatment effectiveness • Increasing awareness and compliance LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  26. Episcan I-200 Ultrasound Scanner Conclusion: • The Episcan I-200 is a valuable tool for pressure ulcer detection and assessment • Can aid in the reduction of the incidence of pressure ulcers • Can aid in the treatment of pressure ulcers • Can aid in the reduction of liability LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

  27. Further Information For further information on this system and its applications and global sales enquiries please contact: PPM Consult Ltd Business web site: PPMconsult.com Medical web site: A1med.net E-mail: info@a1med.net LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC / High-Resolution Ultrasound / LONGPORT, INC

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