Infected abscesses are walled-off collections of pus and bacteria. They are a common sequela of complications in the setting of surgery, trauma, systemic infections and other disease states. Current treatment is typically limited to antibiotics with long-term catheter drainage, or surgical washout when inaccessible to percutaneous drainage or unresponsive to initial care efforts. Antibiotic resistance is also a growing concern. Although bacteria can develop drug resistance, they remain susceptible to thermal and mechanical damage. In particular, short pulses of focused ultrasound (i.e., histotripsy) generate mechanical damage through localized cavitation, representing a potential new paradigm for treating abscesses non-invasively, without the need for long-term catheterization and antibiotics. In this pilot study, boiling and cavitation histotripsy treatments were applied to subcutaneous and intramuscular abscesses developed in a novel porcine model. Ultrasound imaging was used to evaluate abscess maturity for treatment monitoring and assessment of post-treatment outcomes. Disinfection was quantified by counting bacteria colonies from samples aspirated before and after treatment. Histopathological evaluation of the abscesses was performed to identify changes resulting from histotripsy treatment and potential collateral damage. Cavitation histotripsy was more successful in reducing the bacterial load while having a smaller treatment volume compared with boiling histotripsy. The results of this pilot study suggest focused ultrasound may lead to a technology for in situ treatment of acoustically accessible abscesses.

感染的脓肿是脓液和细菌的封闭集合。它们是手术、创伤、全身感染和其他疾病状态中并发症的常见后遗症。目前的治疗通常仅限于长期使用导管引流的抗生素，或在无法进行经皮引流或对初始护理工作无反应时进行手术冲洗。抗生素耐药性也是一个日益受到关注的问题。尽管细菌可以产生耐药性，但它们仍然容易受到热和机械损伤。特别是聚焦超声的短脉冲（即, histotripsy) 通过局部空化产生机械损伤，代表了一种潜在的非侵入性治疗脓肿的新范例，无需长期导管插入术和抗生素。在这项初步研究中，煮沸和空化组织剥离术治疗被应用于在新型猪模型中开发的皮下和肌肉内脓肿。超声成像用于评估脓肿成熟度，用于治疗监测和治疗后结果的评估。通过对处理前后抽取的样品中的细菌菌落进行计数来量化消毒。对脓肿进行了组织病理学评估，以确定由组织切除术治疗和潜在的附带损害引起的变化。与沸腾组织分析相比，空化组织分析更成功地减少了细菌负荷，同时具有更小的治疗量。这项初步研究的结果表明，聚焦超声可能会导致一种技术声学可达性脓肿的原位治疗。