Treatment of chronic wounds by means of electric and electromagnetic fields

Abstract

Subjects with spinal cord injury are often distressed by pressure sores, which usually appear after prolonged pressure (wheelchair, bed) across the soft tissue which has already lost sensibility and has diminished microcirculation. The healing ability and its dynamics depend on the state of the subject's overall health. Consequently, evaluation of a particular treatment requires careful consideration of as many as possible of the parameters relevant to healing and an adequate criterion for assessing the state of the pressure sore. Bearing in mind these two circumstances, the results of a multicentre clinical study are analysed. The aim of the study was to test two hypotheses: first that healing is faster when sores are also treated by electric currents (ECs) (in addition to conventional treatment); and secondly that there exist differences in the efficiency of the treatment if direct or low-frequency pulsed currents (FES parameters) are applied. The data analysed show that pressure sores are likely to heal twice as fast when treated with low-frequency pulsed currents. EC seems to improve the healing rate in cases where the natural healing mechanisms of the body are not sufficient (chronic wounds, older subjects).

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

“…From measured diameters, the wound area, the perimeter, and the width-to-length ratio were calculated. Therefore, to measure wound extent it is sufficient to take a measure of mutually perpendicular diameters, which are the easiest and the quickest measurements that can be performed at bedside [STEFANOVSKA ET AL., 1993]. Wound depth measurement is invasive, because we have to insert our measuring device into the wound.…”

Electrical stimulation therapy to promote healing of chronic wounds: a review of reviews

“…Table 2 is a summary of controlled clinical trials where E-Stim was used to treat three of the main types of chronic wounds (pressure injuries, [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] venous ulcers and other wounds of the lower extremity, [45][46][47][48][49][50][51][52][53] and diabetic and/or ischemic ulcers [54][55][56][57][58][59][60] ). This chart of controlled clinical trials does not include three studies that were found to have the same data presented in another publication -referred to as …”

“…[61][62][63] Twenty-two of these 33 studies used a prospective randomized study design where wound healing outcomes were collected systematically using valid outcome measures and well over 80% of subjects completed the study protocol. [29][30][31]33,34,37,39,[42][43][44][45][48][49][50][51][52][53][54][55][56][57]59 Although data from a control group that did not receive EST was included in the report and analyses, eleven studies had key methodological flaws and were labeled "controlled trial" (CT) since they did not use a random allocation method 36,38,40 or involved fewer than 10 subjects per group. 28,35,38,41,46,47,58,60 The majority of the controlled studies involved the use of relatively small number of subjects and seldom were the large-scale multicenter trials coordinated by industry.…”

“…28,35,38,40,41,46,47,50,53,58,60 Research that focused on pressure ulcer treatment using EST is most common. A total of 27 clinical reports evaluated the effect of EST on people with pressure ulc ers, [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]64,67,[69][70][71]74,75,77,79,82,[85][86][87] and 17 of these were controlled clinical trials. [28][29][30][31][32][33][34][35][36][37]…”

Quantification of MSCs involved in wound healing: use of SIS to transfer MSCs to wound site and quantification of MSCs involved in skin wound healing

“…The wound-healing rate is defined as the gross epithelialization of the wound site. Estimates of wound area can be calculated from the product of two mutually perpendicular perimeters, or by calculation of the area of a circle or ellipse from measured diameters (Stefanovska et al, 1993). A higher wound closure was observed in the SIS + MSCs wound than in the control wound over days 7, 10 and 14 (see Figure 3B).…”