Effect of Electrical Stimulation on Chronic Leg Ulcer Size and Appearance

Abstract

Background and Purpose. Electrical current has been recommended for use on chronic pressure ulcers; however, the ability of this modality to improve healing of other types of chronic ulcers is less well established. The purpose of this study was to examine the effect of high-voltage pulsed current (HVPC) on healing of chronic leg ulcers. Subjects. Twenty-seven people with 42 chronic leg ulcers participated in the study. Methods. The subjects were separated into subgroups according to primary etiology of the wound (diabetes, arterial insufficiency, venous insufficiency) and then randomly assigned to receive either HVPC (100 microseconds, 150 V, 100 Hz) or a sham treatment for 45 minutes, 3 times weekly, for 4 weeks. Wound surface area and wound appearance were assessed during an initial examination, following a 1-to 2-week period during which subjects received only conventional wound therapy, after 4 weeks of sham or HVPC treatment, and at 1 month following treatments. Results. The results indicated that HVPC applied to chronic leg ulcers reduced the wound surface area over the 4-week treatment period to approximately one half the initial wound size (mean decreaseϭ44.3%, SDϭ8.8%, rangeϭ2.8%-100%), which was over 2 times greater than that observed in wounds treated with sham units (mean decreaseϭ16.0%, SDϭ8.9%, rangeϭϪ30.3%-83.7%). Discussion and Conclusion. The results of the study indicate that HVPC administered 3 times a week should be considered to accelerate wound closure of chronic leg ulcers. [Houghton PE, Kincaid CB, Lovell M, et al. Effect of electrical stimulation on chronic leg ulcer size and appearance. Phys Ther. 2003;83;17-28.]

Electrical stimulation vs. standard care for chronic ulcer healing: a systematic review and meta‐analysis of randomised controlled trials

“…A further 12 studies were found on reference review [50][51][52][53][54][55][56][57]. Full articles of the remaining 45 studies were collected and evaluated 21 studies met our inclusion criteria and were included in the meta-analysis [9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] ( Table 2). The reasons for excluding the 23 studies were a nonrandomised design [10][11][12]16,17,[20][21][22][23]44,53,54,56,57], different outcome measures such as limb salvage or oedema reduction [13,14,19,[50][51]…”

“…Our analysis included 21 trials [9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] and 866 patients of whom 34 were randomised in one parallel nonplacebo singleblind trial [38], 50 were randomised in one parallel nonplacebo double-blind trial [40], 138 were randomised in three parallel nonplacebo open trials [31,34,35], eight were randomised in one parallel-placebo single-blind trial [33], 246 were randomised in six parallel-placebo double-blind trials [28][29][30]32,37,39] and 390 were randomised in nine parallel-placebo open trials [9,24-27, 36,41-43]. The mean age of patients ranged from 29Á25 [32] to 83Á0 [36] years.…”

“…The mean age of patients ranged from 29Á25 [32] to 83Á0 [36] years. The aetiology of ulcers varied between trials with 11 studies examining pressure ulcers [9,[24][25][26][27]31,33,[35][36][37]43], three studies examining venous ulcers [28,29,40], two studies examining diabetic ulcers [41,43], one study examining arterial ulcers [52] and four examining ulcers of mixed aetiology [30,34,38,39].…”

“…The outcome measures varied between the trials with 12 trials examining the percentage change in wound surface area over the study period [9,24,26,27,29,[31][32][33][34][37][38][39][40][41][42][43][44]. The remaining trials examined the change in size over the study period in centimetre square (cm 2 ) [24,25,[27][28][29][30]34,36].…”

“…Mean percentage change in ulcer size over total studies periods. Electrical stimulation effect on percentage change in ulcer size over the total studies periods was assessed in six RCTs [26,32,[37][38][39][40]. These studies included a total of 210 patients.…”