DC electrical stimulation for chronic wound healing enhancement Part 1. Clinical study and determination of electrical field distribution in the numerical wound model

Karba, Rihard; Šemrov, Dejan; Vodovnik, L.; Benko, H.; Sˇavrin, Rajmond

doi:10.1016/s0302-4598(96)05192-6

Cited by 49 publications

(70 citation statements)

References 13 publications

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“…Although many clinical articles support the use of ES for wound healing [20][21][22][23][24][25], the mechanism by which ES induces wound healing is not well known. Many evidences implicate VEGF as a significant factor in wound healing immediately after injury [2,[5][6].…”

Section: Discussionmentioning

confidence: 99%

Effect of sensory and motor electrical stimulation in vascular endothelial growth factor expression of muscle and skin in full-thickness wound

Asadi¹,

Torkaman²,

Hedayati³

2011

JRRD

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Abstract-Vascular endothelial growth factor (VEGF) is important in improving wound healing. We evaluated the effect of sensory (direct current, 600 microamperes) and motor (monophasic current, pulse duration 300 microseconds, 100 Hz, 2.5-3.0 mA) intensities of cathodal electrical stimulation (ES) current to release VEGF in muscle and skin in the wound site. We randomly assigned 48 male Sprague-Dawley rats into one control and two experimental groups (sensory and motor ESs). A fullthickness skin incision was made on each animal's dorsal region. The experimental groups received ES for 1 h/day every other day. In the control group, no current was applied. VEGF expression was measured in muscle and skin on the third and seventh days after surgical incision. Our outcomes demonstrated that no difference was found in the VEGF levels among groups on the third day. However, on the seventh day, the skin VEGF levels in the sensory group were significantly higher than those levels of the other groups (p < 0.05). No difference was found in the muscle VEGF levels on the third and seventh days. The results showed that sensory ES increases the release of more VEGF in skin. This mechanism may be one through which a sensory type of current is more effective in promoting wound healing.

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Section: Discussionmentioning

confidence: 99%

Effect of sensory and motor electrical stimulation in vascular endothelial growth factor expression of muscle and skin in full-thickness wound

Asadi¹,

Torkaman²,

Hedayati³

2011

JRRD

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“…Since Jerčinović et al (1994) showed that stimulated wounds were healing significantly faster than conservatively or sham treated wounds, it was not ethical to keep including patients in those groups. After Karba et al (1997) reported that electrical stimulation with direct current is effective only if positive electrode is placed on the wound surface, which is an invasive method, only stimulation with biphasic current pulses was used. Therefore, the group of patients stimulated with biphasic current pulses is larger than other groups of patients.…”

Section: Wound Patient and Treatment Datamentioning

confidence: 99%

Prognostic factors in the prediction of chronic wound healing by electrical stimulation

Cukjati

Robnik–Šikonja

Rebersek

et al. 2001

Med. Biol. Eng. Comput.

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-The aim of the study was to determine the effects of wound, patient and treatment attributes on wound healing rate and to propose a system for wound healing rate prediction. Predicting the wound healing rate from initial wound, patient and treatment data collected in our database of 300 chronic wounds was not possible. After considering weekly follow-ups, we determined that the best prognostic factors were weekly follow-ups of wound healing process, which alone were found to accurately predict the wound healing rate after minimal follow-up period of four weeks (at least five measurements of wound area). After combining them with wound, patient and treatment attributes, minimal follow-up period was reduced to two weeks (at least three measurements of wound area). After follow-up period of two weeks, we were able to predict the wound healing rate of an independent test set of chronic wounds with relative squared error 0.347, and after three weeks with relative squared error 0.181 (using regression trees with linear equations in its leaves). Results show that the type of treatment is just one of many prognostic factors. Arranged in the order of decreasing prediction capability, prognostic factors are: wound size, patient's age, elapsed time from wound appearance to the beginning of the treatment, width-to-length ratio, location and type of treatment.The data collected up to now strongly support our former findings that the biphasic and direct current stimulation contributes to faster healing of chronic wounds.Presented regression trees in combination with the mathematical model of the wound healing process dynamics represent a core of a prognostic system for the chronic wound healing rate prediction. If the wound healing rate is known, then the provided information can help to formulate appropriate treatment decisions.

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“…Based on these findings, anodal microamperage DC ES can improve wound closing by accelerating the endogenous bioelectric events of the wound and attracting the epithelial cells. Karba et al reported that the endogenous electric conditions in the skin were closely approximated with external ES when the wound surface was covered with the positive stimulation electrode while the negative electrode was applied to the tissue surrounding the wound [9].…”

Section: Discussionmentioning

confidence: 99%

“…During the last several decades, many physical modalities, including ultraviolet radiation, electrical stimulation (ES), pulsed electromagnetic fields, low-energy laser, and ultrasound, have been used to promote wound healing [1][2][3][4][5][6][7]. Of all the physical modalities used to augment wound healing, the greatest amount of evidence supports the use of ES [1,[8][9][10][11][12]. These studies evidenced two important findings.…”

Section: Introductionmentioning

confidence: 99%

Effect of anodal and cathodal microamperage direct current electrical stimulation on injury potential and wound size in guinea pigs

Talebi

Torkaman²,

Firoozabadi³

et al. 2008

JRRD

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Abstract-Injury potential may have a regulatory role in the wound healing process, and exogenous electrical stimulation (ES) may mimic natural endogenous bioelectric current that can improve wound healing. Until now, the influence of externally applied ES on injury potential has not been demonstrated during the healing of acute wounds. Thirty-nine male guinea pigs were randomly divided into a control group (sham treatment) and two experimental groups: anodal and cathodal direct current (DC). A 2.5 cm-long full-thickness skin incision was made on each animal's dorsal region. Differential skin surface potential was measured before and immediately after the injury and also through day 21 of the healing period; wound surface area (WSA) was also measured throughout the 21-day healing period. Immediately after injury, wound potential significantly increased in all three groups, reaching a maximum on day 1 for the control and cathodal groups and day 3 for the anodal group (p < 0.05), then decreasing through the healing period. Wound potential returned to preinjury levels by the end of the healing period in the anodal group only. By days 19 and 21, wound potential had decreased more for the anodal group than the control group (p < 0.05). By day 15 for the anodal group and day 17 for the cathodal group, WSA had decreased more compared with the control group (p < 0.05). Anodal microamperage DC ES is appropriate for improving the healing of acute skin wounds because it causes both the wound surface to close and the wound potential to return to preinjury levels faster.

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DC electrical stimulation for chronic wound healing enhancement Part 1. Clinical study and determination of electrical field distribution in the numerical wound model

Cited by 49 publications

References 13 publications

Effect of sensory and motor electrical stimulation in vascular endothelial growth factor expression of muscle and skin in full-thickness wound

Effect of sensory and motor electrical stimulation in vascular endothelial growth factor expression of muscle and skin in full-thickness wound

Prognostic factors in the prediction of chronic wound healing by electrical stimulation

Effect of anodal and cathodal microamperage direct current electrical stimulation on injury potential and wound size in guinea pigs

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