Effects of a pulsatile electrostatic field on ischemic injury to the diabetic foot: Evaluation of refractory ulcers

Liani, Mario; Trabassi, Ernesto; Cusaro, C; Zoppis, E.; Maduli, E.; Pezzato, Roberto; Piccoli, P; Maraschin, Maddalena; Bau, Piero; Cortese, Pietro; Cogo, Albero; Salvati, F; Liani, Rossella

doi:10.1016/j.pcd.2013.11.009

Cited by 9 publications

(16 citation statements)

References 15 publications

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“…A recent review has highlighted that only studies that used electrical stimulation with AC or DC currents have obtained healing of ulcers [39]. In previous study, patients with T2DM and with foot ulcers, but not in hemodialysis, showed an improved rate of healing and a reduction in pain levels after PESF treatment [28]. We have examined platelet surface receptors (GPIIb/IIIa and GPIb) in hemodialysis patients with AV fistulae and correlated with the incidence of clogging of fistulas [40].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with foot ulcers have a poor long term prognosis with a 3yr mortality of 35-40% [27]. In a previous study we have shown that these changes induced by Pulsating Electrostatic Field (PESF) therapy could improve outcomes in refractory foot ulcers in patients with T2DM [28]. We have extended our earlier study to determine if PESF therapy could induce benefit in patients with T2DM and CKD undergoing dialysis, if there were differences between obese or not patients and if there were relationships between nitric oxide levels, exposure to PESF and some comorbidity of disease.…”

Section: Introductionmentioning

confidence: 99%

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Pulsed Electrostatic Field (PESF) and Patients with Type 2 Diabetes Undergoing Hemodialysis: Endothelial Dysfunction and Altered Hemostasis

Liani¹

2018

MJCCS

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Backgrounds: Patients with chronic kidney disease and with diabetes mellitus type 2 have a high incidence of micro and macroangiopathy. Availability impaired of Nitric Oxide (NO) endogenous, consequent to endothelial dysfunction, can lead to peripheral vasoconstriction, altered hemostasis, enhanced platelet activation and altered permeability of vascular wall. Methods: Two groups of patients with type 2 diabetes, ischemic foot ulcers and receiving hemodialysis, were exposed or not to Pulsed Electrostatic Field Therapy (PESF). We also valued if the effects of PESF treatment on wound healing were influenced by the presence or not of obesity. Results: We found statistically significant differences from controls in body weight, systolic and diastolic pressure, heart rate and frequency of peripheral pulsations. Mean blood NO levels were significantly elevated in the treated group. Groups of patients obese and not obese treated with PESF there was a highly significant increases in the rate of wound healing as determined by ulcer area but not in untreated patients. Conclusions: Positive changes were found in body weight, cardiovascular function and platelet behavior. PESF is a promising new technique for the management of diabetic foot ulcers and further studies appear to be warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pulsed Electrostatic Field (PESF) and Patients with Type 2 Diabetes Undergoing Hemodialysis: Endothelial Dysfunction and Altered Hemostasis

Liani¹

2018

MJCCS

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“…One small poorly designed, "randomly assigned" study of pulsating electrostatic field reported benefit on ulcer area reduction in ischaemic refractory ulcers. 200 A nonblinded dose-ranging RCT on non-contact low-frequency ultrasound reported greater ulcer area reduction with thrice weekly applications, but there were only four patients in each of the three groups. 201 In addition to the earlier discussed RCT, which studied adjuvant photon therapy with NPWT, 65 we also identified two controlled studies at a high risk of bias, exploring the effect of photodynamic therapy 202 and phototherapy.…”

Section: Normothermic/infrared Radiation/ Radiotherapy/electrostatimentioning

confidence: 99%

“…One small poorly designed, “randomly assigned” study of pulsating electrostatic field reported benefit on ulcer area reduction in ischaemic refractory ulcers . A nonblinded dose‐ranging RCT on non‐contact low‐frequency ultrasound reported greater ulcer area reduction with thrice weekly applications, but there were only four patients in each of the three groups …”

Section: Physical Therapiesmentioning

confidence: 99%

Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: a systematic review

Vas

Rayman

Dhatariya

et al. 2020

Diabetes Metabolism Res

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The management of diabetic foot ulcers (DFU) remains a challenge, and there is continuing uncertainty concerning optimal approaches to wound healing. The International Working Group of the Diabetic Foot (IWGDF) working group on wound healing has previously published systematic reviews of the evidence in 2008, 2012 and 2016 to inform protocols for routine care and to highlight areas which should be considered for further study. The working group has now updated this review by considering papers on the interventions to improve the healing of DFU's published between June 2014 and August 2018. Methodological quality of selected studies was independently assessed by a minimum of two reviewers using the recently published 21‐point questionnaire as recommended by IWGDF/European Wound Management Association, as well as the previously incorporated Scottish Intercollegiate Guidelines Network criteria. Of the 2275 papers identified, 97 were finally selected for grading following full text review. Overall, there has been an improvement in study design and a significant rise in the number of published studies. While previous systematic reviews did not find any evidence to justify the use of newer therapies, except for negative pressure wound therapy in post‐surgical wounds, in this review we found additional evidence to support some interventions including a sucrose‐octasulfate dressing, the combined leucocyte, fibrin and platelet patch as well as topical application of some placental membrane products, all when used in addition to usual best care. Nonetheless, the assessment and comparison of published trials remains difficult with marked clinical heterogeneity between studies: in patient selection, study duration, standard of usual care provision and the timing and description of the clinical endpoints.

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“…In vivo, the physical source increases calcium in the bones of women with osteoporosis, accelerates consolidation of fractures of the bones, inducing increased base level metabolism, and contributes to accelerating the healing of serious wounds [19][20][21][22][23].…”

Section: The Charge Creates Both a Positive And Negative Reactionmentioning

confidence: 99%

Reversibility of Endothelial Dysfunction Induced by Low Frequency of Electromagnetic Field in Patients with Diabetes Mellitus in Dialysis Extracorporeal

Liani¹

2018

MJCCS

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Aims: The life expectancy of patients with Type II Diabetes Mellitus (T2DM) and Diabetic Foot Syndrome (DFS) is dramatically short. The micro-angiopathy, in relation to endothelium dysfunction, decisively affects the vascular prognosis, perhaps more than macro-angiopathy. Increased availability of nitric oxide (NO) can cause numerous and predictable positive effects in relation to the different mechanisms of macro and micro vascular disease. Methods: We measured NO blood in a group of patients with T2DM on dialysis before and after a Pulsating Electromagnetic Fields (PEMF) cycle and we tested, meanwhile, the reaction of surface receptor platelets GPIb and GPIIb/IIIa. Results: The magnetic field causes an increase in the level of NO, probably due to a prolonged period of exposure, and a modification in the percentage of platelets type and causes a normalisation of the platelets surface receptors in renal patients in dialysis with T2DM. Conclusions: The physical source, although, further investigation is required, can be instrumental in contributing to help with the complications of vascular macro and microcirculation. In our case the increase of NO had caused important

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Effects of a pulsatile electrostatic field on ischemic injury to the diabetic foot: Evaluation of refractory ulcers

Cited by 9 publications

References 15 publications

Pulsed Electrostatic Field (PESF) and Patients with Type 2 Diabetes Undergoing Hemodialysis: Endothelial Dysfunction and Altered Hemostasis

Pulsed Electrostatic Field (PESF) and Patients with Type 2 Diabetes Undergoing Hemodialysis: Endothelial Dysfunction and Altered Hemostasis

Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: a systematic review

Reversibility of Endothelial Dysfunction Induced by Low Frequency of Electromagnetic Field in Patients with Diabetes Mellitus in Dialysis Extracorporeal

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