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Hitachi Healthcare America

Overview

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Wound care treatment has seen some major advances over the years, but methods for accurate wound assessment have remained expensive and often underutilized.

Working with clinicians at the forefront of wound care, Hitachi Healthcare has developed unique ultrasound technology that can help you quickly and accurately assess your patients' wounds and set them on the road to recovery.

Wound Mapping® Allows You to:

  • Visualize and Measure Occult Pathology
  • Evaluate Soft Tissue and Cortical Bone Surface
  • Discover Occult Pathology such as Osteomyelitis
  • Visualize Blood Flow to the Wound Bed


Immediately – in Your Clinic – at Your Patient's Bedside


Technology

Wound Assessment Clearly Defined

Using the Wound-Mapping® Ultrasound Assessment Method, evaluation of both soft tissue and the cortical surface of bone in and around a chronic ulcer may be achieved.

Besides being painless to patients, it is a powerful and easy-to-use diagnostic method to examine below the wound's surface. Now you can define wound etiology, "see" hidden pathology, take precise measurements, accurate labeling and documentation, determine proper treatments, and monitor the healing process in three easy steps.

Step 1 - Prepare the Transducer                                             Step 2 - Prepare the Wound                                                   Step 3 - Start Scanning
Wound Mapping - Prepare the Transducer                           Wound Mapping - Prepare the Wound                                  See Wound-Mapping in Action

Wound           wound-mapping-step-2           wound-mapping-step-3


Wound-Mapping® Ultrasound Allows You to Qualify and Quantify:

  • Wound Depth
  • Thickness of Tissue Over Bone
  • Extent of Undermining
  • Blood Flow to Wound Base
  • Bone Invasion (Osteomyelitis)


Positive Indication Osteo

Wound-Mapping® Ultrasonic Assessment of a diabetic foot. This scan of the plantar mid-foot revealed an irregular periosteal surface with interruption of cortical bone. Note on the mid-right side of the image a hypo to anechoic area showing a periosteal abscess. These ultrasonic impressions are commonly seen in osteomyelitis. Ultrasound was then used to guide a needle to obtain a biopsy confirming this diagnosis.

Positive Indication Osteo


Foreign Body Two View Staple

Two views of a non-healing, post-operative wound of the upper right quadrant of the abdomen. Note that in a longitudinal scan (right side of image) starting at the skin surface there is an anechoic area that penetrates into the abdomen. Within that scan, a bright hyperechoic object is seen. A second scan (transverse position, left image, see arrow) at the same depth the hyperechoic object is again visualized. This turned out to be a metallic staple left in the wound post-surgical, which was then removed allowing the patient to heal.
2_Foreign-Body-Two-View-Staple

Measurement Stage IV Pressure Ulcer

This is a longitudinal Wound-Mapping® scan of an ischial pressure ulcer. What is noted here is the width and depth of the ulcer. Note that the tissue void presents as a conical tissue void. To the right side of the image the ischium is noted to have an irregular cortical surface. This scan allows for accurate measurements of the pressure ulcer.

3_Measurement-Stage-IV-Pressure-Ulcer


Foreign Body Within Abscess

This a non-healing wound in an area of an abscess. This longitudinal Wound-Mapping® scan reveals what appears to be a foreign body with this region (between arrows). This type of imaging provides a non-invasive method to determine the exact location of foreign bodies. Ultrasound is used to guide the practitioner during the removal of foreign bodies.

4_Foreign-Body-Within-Abscess


Blood Flow Visualization

A Wound-Mapping® ultrasound image of a diabetic foot ulcer at the base of the 5th metatarsal. Note that the cortical surface is irregular and appears to be invaded. This is most probably secondary to a bone infection, (osteomyelitis). Further, note that the duplex color doppler indicates increase blood flow to the region of interest.

5_Blood-Flow-Visualization


Measurement

Diagnostic ultrasound images of a pressure ulcer of the coccyx. In this longitudinal scan, the tissue void is clearly visualized. The coccyx cortical surface is noted and appears intact. Further, this scan easily shows the amount of tissue that still covers the surface of the coccyx.

Measurement


Sinus Tract Pressure Ulcer

Wound-Mapping® ultrasound of a sacral pressure ulcer. Starting at the skin surface (upper left side of image), a sinus tract is noted that travels deep and distal into the sacral region. Note that the tract does not appear to penetrate to the level of bone. Ultrasound guidance was then used to monitor and follow the sinus tract during the treatment process.

7_Sinus-Tract-Pressure-Ulcer



PictZar® Digital Planimetry Software Provides:

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  • Simple Calibration of Wound Images
  • Accurate Surface Area Measurements
  • User Addition of Depth Measurements
  • Robust Reporting Package
  • PUSH Report with Graph
  • Tracking of Wound Progress over Time
  • Digital and/or Hardcopy Archive

Noblus Features

L64 High Frequency Transducer

This wide band, linear transducer has a frequency range from 5 MHz to 18 MHz making it ideal for wound assessment. The L64 features the exclusive Hitachi Healthcare Scan Assist feature which displays reference lines in the ultrasound image that correlate to the markings on the transducer housing. This allows an enhanced understanding of the wound's shape and size. Having a correlation between markings on the L64 transducer housing and reference lines on the ultrasound image is especially useful while performing ultrasound-guided biopsies and aspirations.

Scan Assist

The L64 high frequency linear transducer allows easy wound care measurement by providing marks at 5mm increments on the transducer housing. These marks correlate to reference lines superimposed on the ultrasound image providing convenient guidance for biopsies and aspirations.

Extended Field of View

Provides an extended field-of-view image created from a series of real-time images. As the user moves the transducer across the area of interest a larger image is created providing clear spatial relationship information of anatomy and structures. This is especially helpful in assessing structures that are larger than the transducer field of view.
Extended Field of View

Convenient Wound Reporting

 

Noblus Ergonomics

 

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The importance of ergonomically designed ultrasound systems cannot be understated. We designed Noblus to minimize repetitive stress while maximizing flexibility across your hospital, imaging center and private practice.

  • Adjustable cart height allows excellent ergonomic operation from a standing or sitting position.
  • The swivel screen, integral Palm rest and widely spaced cart wheels allow the ultimate in operator comfort.
  • The unique detachable housing with flip up panel allows examinations to be performed either on a counter or slim roll around cart.
  • Smart touch feature allows you to adjust imaging parameters while keeping eyes on the screen.
  • Newly designed probe connectors allow the operator to attach and detach with one hand
  • Probe add-on unit allows up to 3 probes to be connected, enabling easier switching.
  • Cart has a built in battery and a space for mounting a printer. This offers superb portability and eliminates system shut down between exams.
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Noblus Image Technology

 

Clear images and advanced functions are what you have come to expect from Hitachi – Aloka. Our 60 years of experience and innovation continues with the Noblus platform.

  • Ultrasound Broadband Engine (Ultra BE) – The most advanced broadband beam-forming technology combined with high speed image processing that allows for higher definition ultrasound imaging than ever before.
  • HI Definition Tissue Harmonic Imaging (HdTHi) – Provides high quality imaging using an expanded range of harmonic signals. This technology results in excellent image resolution and sensitivity and improved penetration.
  • HI REZ Clearly displays differences in tissues, reducing speckle noise while maintaining the frame rate. It can also display outlines more clearly by selectively emphasizing boundaries.
  • Spatial Compound Imaging (SCI) – The ultrasound beam is transmitted and received in real time and in the multiple directions resulting in a reduction of speckle noise, suppression of artifacts, and improvement of contrast resolution allowing lesions to be clearly observed.
  • HI Support - At the touch of a button the B-mode image is instantly optimized to the user’s preference. This technology continually monitors the user’s typical settings to optimally adjust the image when pressed resulting in less manual adjustments and more efficient examinations.
  • Single Crystal Probes – A single crystal is used to provide the piezoelectric elements of the probe. Single crystal technology achieves higher sensitivity and wider bandwidths over standard piezoceramics.

 

CPT Codes

CPT Codes for Wound-Mapping


Queries and responses from the American Medical Association on the clinical application of Wound-Mapping® when imaging wounds using diagnostic ultrasound.

Pressure Ulcer Undermining


Patient has a history of a non-healing pressure ulcer of the sacrum. Patient had been treated for over 8 months using numerous wound dressings and a turning schedule. The wound was highly draining with foul odor. Patient was sent for evaluation of the wound and to examine for the possibility of osteomyelitis of the sacrum.

Foreign Body in Wound


Patient has a history of carcinoma in situ with surgical excision. Patient also has an abdominal hernia repair with mesh. Patient presented with a small chronic non-healing wound that had been draining clear non-infected fluid for 6 months. Patient was referred for evaluation and treatment of the wounds.

Osteomyelitis of Sacrum


Patient has a history of a non-healing pressure ulcer of the sacrum. Patient had been treated for over two years using numerous wound dressings, an off-loading wheelchair cushion, and specialized beds. Patient was sent for evaluation and management of the pressure ulcer.

Osteomyelitis & Abscess of Foot


Patient has a history of a non-healing diabetic foot ulcer of the left foot. The patient, who is neuropathic and has no sensation in the foot, had been treated for 2 months using multiple off-loading devices, debridement, and local care. Patient was subsequently referred for evaluation and treatment of his foot ulcer.

Neuropathic Ulcer – X-ray Vs. High Resolution Ultrasound


Patient has a history of a neuropathic ulcer 2nd to alcohol abuse . Has had previous amputation of digits due to frost bite . Patient has been treated with various off-loading shoes and numerous topical wound medications . Ulcer has failed to respond to traditional standard of care treatment .

L64

High Frequency Transducer

A wide band, linear transducer perfectly tuned for wound care assessment. The L64 supports the exclusive Hitachi Healthcare Scan Assist feature which displays reference lines in the field of view that correlate to the markings on the transducer housing. This allows an enhanced understanding of the wound shape and size.

Main Specifications:
•Array Type: Linear
•Frequency Range: 18 - 5 MHz
•Scan Width: 38 mm Width
•Smart Connector

Hydrostep

SoundSeal

Video

PictZar (R) Digital Planimetry Software

PictZar® Digital Planimetry Software Provides: •Simple Calibration of Wound Images •Accurate Surface Area Measurements •User Addition of Depth Measurements •Robust Reporting Package •PUSH Report with Graph •Tracking of Wound Progress over Time •Digital and/or Hardcopy Archive

Video

Wound Mapping Ultrasound

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