CHAPTER NINETEEN: Ultraviolet C

CHAPTER OBJECTIVES

At the end of this chapter, the learner will be able to:

1. Define terms describing the use of ultraviolet C including electromagnetic spectrum, ultraviolet radiation, minimal erythemal dose (MED), and the cosine law.

2. Explain how the application of ultraviolet C to a chronic wound generates a bactericidal effect.

3. Develop safe and appropriate application parameters for ultraviolet C in wound healing.

4. Select specific patient indications appropriate for the use of ultraviolet C in wound management.

5. Identify precautions and contraindications for the use of ultraviolet C.

6. Select safe and appropriate parameters for ultraviolet C application.

7. Develop and implement a care plan involving the use of ultraviolet C in the treatment of a chronic wound.

INTRODUCTION

Although ultraviolet A (UVA) and ultraviolet B (UVB) have been used in health care for some time to treat dermatological conditions such as psoriasis and also have evidence to support the use of ultraviolet radiation to promote wound healing, ultraviolet C is the type of ultraviolet light that is most commonly utilized today in the treatment of chronic wounds^{1, 2}. Specifically, ultraviolet C (UVC) is beneficial for the treatment of chronic wounds due to its bactericidal effect.³ As the number of drug-resistant organisms continues to increase, wound clinicians must consider treatment options that not only effectively destroy bacteria without damaging fibroblasts and other cells necessary for wound healing, but also avoid the development of resistance.⁴ Ultraviolet light C accomplishes both of these treatment goals and is a cost-effective, portable, and safe treatment modality.^{5, 6}

THEORY

Understanding the types of ultraviolet light is important in order to choose a wavelength that will deliver the desired outcome (TABLE 19-1, FIGURE 19-1). This chapter focuses on ultraviolet C, which has FDA approval for use on open wounds due its bactericidal effects.^{7, 8} TABLE 19-2 provides terminology and definitions utilized in the discussion of ultraviolet light. Handheld ultraviolet C devices consist of lamps that deliver ultraviolet light at a specific wavelength (254 nm), which falls within the optimal wavelength range for bacterial reduction.^{9, 10} These devices contain filters specific to UVC that reduce the risk of skin cancer and skin burns often associated with UVA and UVB.¹¹ Although studies have shown an increase in risk of skin cancer associated with the use of ultraviolet B, there has been no link reported between skin cancer and UVC.^{11, 12}