Fig. 4.

Monitoring wound progression using ultrasound. Patient B was a 33-y-old man with an anterior lower limb wound who received an allogenic skin graft 49 d into the study. Photographs and US images from Site ii (red dotted line) and superior healthy tissue (green dotted line) from (a–c) day 1, (d–f) day 42, (g–i) day 62, (j–l) day 84 and (m–o) day 106. Signs of tissue loss (b) can be seen using US while not visible to the eye (a). An increase in wound size and hypo-echoic regions were observed (b, e, h) over the first 62 d, indicating tissue loss even though skin grafting was done on day 49. An increase in echogenicity indicating tissue regeneration and wound contraction can be seen between days 62 and 106 (k, n). The ability to monitor tissue loss and regeneration under a skin graft between days 49 and 62 and days 62 and 106, respectively, illustrates the main power of imaging over current methods. Superior healthy control tissue (green dotted line) remains fairly unremarkable and unchanged over the same period. Red arrows point to wound site; yellow arrows point to the tibia. All bars = 1 cm. US = ultrasound.