Behandlung von venösen Ulzera mit niederfrequentem gepulstem Strom (Dermapulse): Effekte auf die kutane Mikrozirkulation

Abstract

Chronic venous insufficiency (CVI) is characterised by stage-dependent microangiopathy. With increasing severity there is a decrease in the number of skin capillaries and the oxygen partial pressure. The cutaneous vascular reserve, which is measured by laser-doppler fluxmetry, is reduced. Cutaneous microangiopathy is one of the main causes of the trophic disturbances associated with CVI. Low frequency pulsed current improves cutaneous microcirculation and thus nutrition as well as accelerating the formation of granulation tissue. In a open prospective pilot study, 15 patients suffering from CVI with persistent leg ulcers were treated with low frequency pulsed current (Dermapulse), which is thought to improve particularly the tissue microcirculation. The average age of the patients was 70.3 years and the average duration of ulceration was 79.1 months. The patients were treated over a period of 38 days. With this treatment, 2 ulcers healed completely and 13 showed a reduction of size of on average 63%. Capillary density increased by 43.5%, while transcutaneous oxygen partial pressure increased by 82.4%. Electrostimulation is a treatment with few or no side effects.

Local therapy and treatment costs of chronic, venous leg ulcers with electrical stimulation (Dermapulse®): A prospective, placebo controlled, double blind trial

“…There have also been reports of antibacterial action 35,9 as well as a cell‐stimulating effect in the sense of elevated DNA, protein and collagen synthesis 36 . In addition, the expression of growth factor receptors is elevated, and the growth of neurites, epidermal cell migration and vascularization are stimulated 7,29,26,20,37 . Macrophages, neutrophilic granulocytes and mast cells display a migratory motion along the current gradient, termed the galvanotaxic effect, which has a beneficial effect on wound healing 29,8,10 .…”

“…3,24,33 Our prospective, clinical, double blind study was not able to establish unequivocally that the improvement in cutaneous perfusion was due to the therapeutic benefit from electrostimulation. 20 However, it must be stressed that there was a significant reduction of pain, which is a central factor in improved quality of life for the patients.…”

“…The Dermapulse ® (Gerromed, Hamburg, Germany) unit is a battery‐driven wound healing stimulator creating a pulse‐controlled electrical stimulation 20 . A 6‐V spring‐terminal type battery powers the unit with a capacity of 20 Ah.…”

Current therapies for wound healing: electrical stimulation, biological therapeutics, and the potential for gene therapy

“…These range from compression bandages as the standard treatment for venous ulcers 30−32 to laser treatment, 33,34 hyperbaric oxygen, 35,36 and electrical stimulation for the treatment of arterial ulcers. One particular regime of electrical stimulation that has achieved some success is the use of Dermapulse, 37,38 which we will review at length.…”

“…In one study, 37 patients with chronic venous insufficiency, who had suffered for years with therapy resistant ulcers, were treated with low‐frequency pulsed current. The patients generally found the treatment to be pleasant.…”