Efficacy of Bimodal High-Voltage Monopulsed Current in the Treatment of Pressure Ulcer: A Systematic Review

Abstract

<jats:p>Background: We aimed to systematically evaluate the efficacy of high-voltage pulsed current (HVPC) in the treatment of pressure ulcer.&#x0D; Methods: We searched the databases of PubMed, Cochrane Library, Elsevier and EMBASE to identify randomized controlled studies on the application of HVPC in pressure ulcer treatment, up to January 2019. Two authors independently screened the literature according to the inclusion and exclusion criteria, extracted the data and evaluated the quality. RevMan 5.3 software was used for statistical analysis. Four randomized controlled trials involving a total of 176 patients were included in the study.&#x0D; Results: Meta-analysis showed that the percentage of wound area reduction in the HVPC treatment group was higher than that in the control group (95%CI 24.59, 47.76, P&lt;0.001). Descriptive analysis showed that there was no significant difference in wound healing between the HVPC treatment group and the control group. One study reported that there was contact dermatitis, and the rest of the studies reported no adverse events.&#x0D; Conclusion: Compared with the conventional therapy, the combination with HVPC therapy can reduce the area of pressure ulcers more effectively. However, due to the small number of the studies included in this evaluation, the conclusions need to be verified by more high-quality studies.</jats:p>

Reliability of evidence supporting the role of electrical stimulation in the treatment of pressure ulcers

“…A total of 100 publications were excluded after reviewing the titles and abstracts, and the remaining 13 literature were further reviewed by reading the full text. Finally, ten eligible SRs/MAs were included 16–25 . The study selection process is depicted in Figure 1.…”

“…Compared with standard care alone or sham electrical stimulation, electrical stimulation resulted in a statistically significant improvement in healed rate 19,20,22,25 . Compared with standard care alone or sham electrical stimulation, electrical stimulation was reported by two reviews resulting in a statistically significant reduction in wound area 21,25 . Similarly, electrical stimulation resulted in a statistically significant improvement in daily percent decrease in ulcer size 19 and the proportion of ulcers healed 22,25 .…”

“…19,20,22,25 Compared with standard care alone or sham electrical stimulation, electrical stimulation was reported by two reviews resulting in a statistically significant reduction in wound area. 21,25 Similarly, electrical stimulation resulted in a statistically significant improvement in daily percent decrease in ulcer size 19 and the proportion of ulcers healed. 22,25 Furthermore, the time to complete healing was reported by one review, and the results indicated that electrical stimulation helped to reduce wound healing time compared to standard care or sham stimulation alone.…”

Effectiveness and safety of electrical stimulation for treating pressure ulcers: A systematic review and meta‐analysis

“…But in our works, all three outcomes have statistical differences between ES groups with the SWC groups or the sham groups. Girgis and Duarte (2018) and Zhang et al (2019) have investigated the HVMPC for treating PUs. Because both are lacking evidence‐based programme and other parameters' current, our study design was more prescriptive, and the focus was more extensive.…”

“…Well‐conducted conventional meta‐analyses of randomized controlled trials (RCTs) are accepted as the best‐quality evidence to inform clinical practice and health policy (Ge et al, 2018; Li et al, 2015). Recently, two systematic reviews and meta‐analyses (Girgis & Duarte, 2018; Zhang et al, 2019) were carried out to investigate the high‐voltage monophasic pulsed current (HVMPC) for treating PUs. They all confirmed that ES has positive effect on PU healing.…”