Flexible electrical stimulation device with Chitosan-Vaseline® dressing accelerates wound healing in diabetes

Abstract

The healing process of diabetic wounds is typically disordered and prolonged and requires both angiogenesis and epithelialization. Disruptions of the endogenous electric fields (EFs) may lead to disordered cell migration. Electrical stimulation (ES) that mimics endogenous EFs is a promising method in treating diabetic wounds; however, a microenvironment that facilitates cell migration and a convenient means that can be used to apply ES are also required. Chitosan-Vaseline® gauze (CVG) has been identified to facilitate wound healing; it also promotes moisture retention and immune regulation and has antibacterial activity. For this study, we created a wound dressing using CVG together with a flexible ES device and further evaluated its potential as a treatment for diabetic wounds. We found that high voltage monophasic pulsed current (HVMPC) promoted healing of diabetic wounds in vivo . In studies carried out in vitro , we found that HVMPC promoted the proliferation and migration of human umbilical vein endothelial cells (HUVECs) by activating PI3K/Akt and ERK1/2 signaling. Overall, we determined that the flexible ES-chitosan dressing may promoted healing of diabetic wounds by accelerating angiogenesis, enhancing epithelialization, and inhibiting scar formation. These findings provide support for the ongoing development of this multidisciplinary product for the care and treatment of diabetic wounds.

Wound healing applications of creams and “smart” hydrogels

“…Results showed that high voltage monophasic pulsed current increased vascular endothelial growth factor levels, promoted cell migration and proliferation and decreased scar tissue formation. 95 …”

Wound Healing with Electrical Stimulation Technologies: A Review

“…The beneficial effect of ES was also seen in other diabetic-related wounds whereby a chronic wound at a post-amputation stump site of nearly 1-year duration closed completely after 45 sessions of ES [102]. In pressure ulcers, amazing recovery was seen in HVMPC [84][85][86]103]. The outcome of ES was comparable to the negative pressure wound therapy (NPWT) in a study of pressure ulcers [104].…”

“…PC is widely studied as it has lesser electrothermal, electrophysical, and electrochemical side effects compared to DC due to the pulsing features of PC [48]. Most PC protocols deliver less than 20 mA, and high voltage monophasic pulsed current (HVMPC), as shown in Figure 4c, is the most common PC with twin spikes of high voltage (100-500 V) current delivered in a pair within 2-50 ms [84][85][86][87]. The field strength, exposure duration, and duty cycle affect the galvanotaxis of cells but not the frequency [48].…”

“…Cathodal stimulation is the preferred polarity in wound healing [84,88,89]. The reason for the cathodal preference is explained in Table 2 in which most skin cells migrate to the cathode, although there were studies that stated no difference in wound healing between cathodal or anodal stimulation [85,86]. Oddly, Souza et al (2018) found that anodal stimulation was better compared to cathodal to stimulate healing and integrate the skin graft [37].…”

LPS-stimulated Macrophage Exosomes Inhibit Inflammation by Activating the Nrf2 / HO-1 Defense Pathway and Promote Wound Healing in Diabetic Rats

“…In the current treatment, the wound healing of diabetes can not be improved [30][31][32]. After the trauma, it will lead to a series of diseases, leading to chronic in ammation and the production of a large number of reactive oxygen species [33,34].…”