Research Article | DOI: https://doi.org/10.31579/2641-0419/598
*Corresponding Author: Hana Zelenková, PhD, MBA SANARE s r.o., Svidník, Slovak Republic.
Citation: Hana Zelenková, (2026), Sonication Applied Beyond the Field of Dermatology Basic Information and Results, J Clinical Cardiology and Cardiovascular Interventions, 9(11); DOI:10.31579/2641-0419/598
Copyright: © 2026, Hana Zelenková. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 21 September 2026 | Accepted: 09 October 2026 | Published: 15 October 2026
Keywords: sonication; bacterial colonization; targeted antibiotic therapy
Background: Sonication is a novel, highly effective laboratory diagnostic method that uses a bioceramic coating and ultrasound to provide more detailed information about bacterial colonisation in non-healing wounds of various aetiologies than standard swabs.
Material and methods: These results are used in clinical practice to guide more targeted and effective antibiotic treatment. They have also been published in renowned journals and presented at European and global conferences. The published results compared bacteriological findings from conventional swabs with those from sonication. The study demonstrated that sonication captured a greater number of bacterial strains. Additionally, biofilm-forming bacteria that were not detected by swabs were identified and confirmed.
Results: The results obtained enabled precise, targeted antibiotic treatment to be initiated, which accelerated healing in 80% of cases until full recovery was achieved.
Conclusion: Sonication is currently used in many dermatology and surgical clinics across Europe. Unfortunately, in Slovakia it is still only used sporadically in isolated cases.
Since the 1970s, there has been a surge in the development of advanced products intended for the treatment of various types of wounds, including venous ulcers, arterial ulcers, mixed ulcers, pressure ulcers, diabetic ulcers, radiation ulcers, and traumatic wounds [1, 4, 6].
These new-generation dressings utilise insights into the pathophysiology of wound healing, particularly with regard to bacterial colonisation of the wound. Nowadays, dermatologists' toolkits for treating such wounds also include new diagnostic procedures, microbiome studies, and other approaches [10, 11, 12, 13, 14, 15].
A standard wound swab is usually used to diagnose microbial or fungal colonisation of a wound. The test results provide information on the presence and quantity of microorganisms and determine their sensitivity to antibiotics. This ultimately enables the physician to initiate effective antibiotic therapy. However, it is not always possible to identify biofilm-forming bacteria, which can result in repeated ineffective treatment. [1].
Consequently, more effective methods are being sought to investigate the colonisation of wounds by microbes. One such method is sonication, an alternative laboratory diagnostic technique which utilises a bioceramic dressing and ultrasound and is exceptionally effective. The bioceramic dressing is placed on the wound, where it absorbs exudate to create a sonicate containing bacteria and endotoxins. This sonicate is then analysed and screened bacteriologically using ultrasound. This procedure provides a reliable assessment of the extent of microbial colonisation in the wound, enabling a practical treatment approach to be taken.
Examinations, treatments and diagnostic procedures are approached as multidisciplinary collaborations, with consultations carried out with other centres in Slovakia and abroad, as well as with the European Wound Management Association (EWMA). During sonication, the WUWHS position papers (e.g., those on exudate management) are fully adhered to [2].
Sonication: definition and application possibilities
Sonication, also known as ultrasound, involves applying high-intensity, low-frequency sound waves to a liquid or paste. Apart from its use in medicine, sonication has been studied for its effects on water conductivity and pH, and for its role in the efficient and controllable synthesis of gold nanoparticles, improving cheese production, ultrasonically decarboxylating cannabinoids and lysing BL21 cells, among many other applications.
In medicine, sonication involves the use of a bioceramic coating, ultrasound and a sonication chamber. The first publications on sonication date back to 2007 [4, 5].
The results published in 2008 were of particular interest from an orthopaedic perspective. At that time, the authors drew attention to the high proportion of negative results in practice, which left orthopaedic surgeons with limited treatment options. They emphasised the importance of incorporating methods into microbiological diagnostics that would increase the yield of cultures, such as sonication. [4, 5].
From 2024 onwards, the number of specialist publications on this subject has increased in both the Czech Republic and Slovakia. From a dermatological perspective, Fárová published an interesting review, which was followed by papers from Zelenková et al. in 2024 and 2025 [1, 9, 10, 11, 12, 13, 14, 15].
Sonication has a wide range of applications in dermatology. These include diagnosing periprosthetic infections and persistent fistulas with negative culture results, as well as chronic non-healing infections and wounds of various aetiologies. It can also be used to treat central venous access sites and other catheters. [3, 6, 4, 13, 15, 16, 17, 18, 19, 20]
Equipment and materials required for sonication
Figure 1: Ultrasonic cleaner
Figure 2: Sonication box with examined material
Figure 3: Sonication tray
Figure 4: Application of bioceramic dressing material, collection and insertion of the material into the sterilisation container filled with normal saline solution.
Procedure:
Before applying the bioceramic dressing, the wound and the surrounding area must be cleaned and the defect bed prepared. The dressing should then be applied in sterile conditions and left in place for 12–24 hours, provided it has not absorbed more than 60 per cent of its surface area. Once removed from the patient's wound, the used bioceramic dressing is placed in a sterile, hermetically sealable container (sonication box) and covered with normal saline. It is essential that the dressing is 90 per cent submerged [8, 9, 10, 11, 12, 13, 14, 15, 23].
The greater the immersion, the lower the sonication efficiency.
The sonication box is then placed in the sonication bath, which is filled with water. The water level in the bath should be the same as the level inside the box. Sonication is started for one minute at a temperature of 23 °C. Once this is complete, the contents of the sonication box are mixed again [8, 9, 10, 11, 12, 13, 14, 15].
Once removed from the bath, the sealed sterile test tube containing the sonicate and the standard sterile control test tube are sent to the laboratory for culture testing [8, 9, 10, 11, 12, 13, 14, 15].
Please note:
The sealed sonication chamber containing the sample must be shaken vigorously by hand (for 30 seconds).
The advantages of using bioceramic dressing material.
The medical device discussed is a bioceramic wound dressing. It is inert and non-allergenic, comprising a pad filled with ceramic granules and lacking an adhesive layer. These granules are highly porous and
permeable, enabling them to absorb wound exudate at a pressure of 933 kPa while retaining it within the wound at 45 kPa. The bioceramic dressing exhibits bacterial retention properties during sonication, providing a more effective diagnostic result than conventional wound swabs [8, 10, 23, 24].
The first cohort, which was studied at our trial centre between April and October 2024, comprised a total of 34 patients. The diagnoses included leg ulcers of various aetiologies and sizes, ranging from a minimum diameter of 10 cm to extensive circular defects. A standard wound swab was taken from each patient, with sonication performed on the same day and at the same time.
Please note:
A sample was taken from the patient during their initial examination. Prior to this, the average duration of non-healing wounds at other centres had been two to five years. Until then, antibiotics had been administered systemically an average of eight to ten times a year, either clinically or based on a culture. According to conventional culture results, antibiotic treatment had only been successful in 30 per cent of cases to date.
Swab comparison
A total of 84 bacterial strains were detected in 34 patients using conventional culture, whereas sonication detected 122 strains. The most significant differences in antibiotic sensitivity were observed among the following bacteria: Enterococcus faecalis, Staphylococcus epidermidis, Staphylococcus haemolyticus, Pseudomonas aeruginosa, Staphylococcus aureus and Proteus vulgaris. Biofilm-forming bacteria were only identified by sonication and not by the standard swab method.
Evaluation of observations and results – conclusions
A study of 34 patients confirmed that both wound swab and sonication capture bacterial strains present in the upper layers of biofilms, such as S. aureus and S. epidermidis.
Bacterial strains present in the deeper layers of the biofilm (P. aeruginosa and others) were detected in 80 per cent of cases through sonication of the bioceramic coating alone. To formulate appropriate systemic antibiotic therapy and inform clinical practice, a rational and realistic assessment of the biofilm is essential, including its deeper layers, to identify the presence of rare and anaerobic bacteria. The primary aim of the examination is to minimise polypharmacy and reduce unnecessary systemic antibiotic administration.
Taking a broader view, healing chronic and extensive defects in polymorbid patients requires a comprehensive, multidisciplinary approach. Studies on sonication suggest that certain medications, such as vitamin K antagonists, may hinder wound healing [1, 7, 10, 12, 15, 16, 17, 18, 19, 20, 21, 22, 23].
Efforts should be made to limit polypharmacy and the administration of unnecessary antibiotics. The sonication method provides more detailed information on bacterial colonisation in non-healing wounds of various aetiologies than standard swab tests do. This information can and should be utilised in clinical practice to enable more targeted and effective antibiotic treatment. The study confirmed this, with the wound bed being cleared in 85% of cases based on culture results, sonication findings and targeted antibiotic administration. This accelerated healing. Not only was healing time significantly reduced, but there were also economic benefits in terms of savings on medical supplies.
In future, sonication should be used more widely for microbiological diagnosis, replacing conventional swabs for various types of lesion, such as acute and chronic wounds, dehiscences, fistulas, traumatic injuries and non-healing post-operative wounds.
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The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
