Electrical stimulation for difficult wounds: only an alternative procedure?

Abstract

In the wound healing research, the exact mechanism of action of different modalities of electrical stimulation (ES) remains controversial and unresolved. In this study we discuss a particular ES, with a different type of waveform, corresponding to the principle of stochastic resonance. Between July 2008 and May 2010, 32 patients were enrolled and ES was applied to wounds using the bioelectrical signal therapy (BST) device (LifeWave, Petach Tiqwa, Israel). The outcome evaluated in group 1 (n = 21) was wound healing, while group 2 (n = 11) was evaluated for wound-related pain [Visual Number Scale (VNS) pain scale] during treatment. In group 1, 87% of the wounds closed in an average time of 97 days (range 10-150 days); three patients were lost to follow-up. In group 2, 45% of the patients experienced a complete pain disappearance after 7 days of treatment; 36% reported a reduction in VNS from 9·3 to 3·2 in 7 days; 19% stopped morphine-like painkillers after 2 weeks. The clinical application of the stochastic resonance enables the usage of easy-to-use, non-invasive, painless and pain-relief treatment. Our experience with ES has demonstrated the BST device to be a very good alternative in cases of small size defects, compared with other therapies such as surgery, dressing and negative pressure devices.

Weak electric fields detectability in a noisy neural network

“…Some studies have proposed SR as a key mechanism in optimizing the performance of specific functional electric stimulation devices, such as hearing implants (Morse and Roper 2000;Zeng et al 2000). Beside this specific application, the functional electric stimulation technique covers a huge class of application fields (Russell et al 1999;Lin et al 2000;Fraccalvieri et al 2015). Transcranial electrical stimulation (TES) with weak currents is actively investigated to treat a range of neurological and psychiatric disorders (Fregni et al 2006;Liebetanz et al 2006), and there is evidence that low-intensity TES can affect ongoing brain activity (Kirov et al 2009;Iliopoulos et al 2014).…”

Nature's Electric Potential: A Systematic Review of the Role of Bioelectricity in Wound Healing and Regenerative Processes in Animals, Humans, and Plants

“…Similar wireless bioelectric dressings generate a micro-electrical field which may augment the natural electric field of injury following wounding (Kim et al, 2014 ), and have bactericidal activity on numerous wound pathogens including multidrug resistant organisms (Kim et al, 2016 ). In another study in chronic wounds unresponsive to conventional therapies, a bioelectrical signal therapy device generating an AC pulse train with a stochastic (random) signal led to 87% of the wounds undergoing closure (Fraccalvieri et al, 2015 ). In an appraisal for the National Health Service (NHS) in the UK, an externally applied electroceutical device was evaluated to be a cost-effective treatment for managing venous leg ulcers, with an improved outcome for less cost, compared with other treatments (Guest et al, 2015 ).…”

“…In recalcitrant wounds, it has been suggested that the endogenous EFs are askew, compromised or absent (Kloth, 2014 ; Fraccalvieri et al, 2015 ). Moreover, diabetic skin has a lower TEP and therefore smaller wound currents (Ionescu-Tírgovişte et al, 1985 ).…”

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

“…These effects could be due to a change of membrane potential and of mitochondrial function and to generation of nitric oxide [38]. 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].…”