Electromagnetic therapy for treating pressure ulcers

Manesh, Alireza Olyaee; Flemming, Kate; Cullum, Nicky; Ravaghi, Hamid

doi:10.1002/14651858.cd002930.pub3

Cited by 14 publications

(8 citation statements)

References 6 publications

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“…Electrical stimulation has also reported to have no induce on wound healing [125], while in other studies electrical stimulation was shown to enhance the rate of pressure ulcer healing compared unstimulated controls [126] However, due to the great differences in the methodologies of electrical stimulation, and differences in electrical field forces used, from weak to high-voltage pulsed galvanic stimulation, and the small numbers of participants involved in most studies, further work is required to determine the validity of electrical stimulation in eliminating pressure ulcers.…”

Section: Electrical Stimulationmentioning

confidence: 99%

Techniques for Wound Healing with a Focus on Pressure Ulcers Elimination

Kuffler¹

2012

TOCVJ

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Pressure ulcers, also called decubitus ulcers, are a common challenge of humanity. They are wounds initiated by pressure on the skin that blocks circulation causing the skin and underlying tissues to die. Without care, pressure ulcers continue to grow in diameter and depth and are exceptionally difficult to heal. They have probably always existed, and are present on Egyptian mummies. Pressure ulcers are a serious health issue, very painful, a significant physiological challenge, can shorten the life of a patient, are an emotional and financial burden to the patient, those who deal with them, and in the United States alone annually costs in excess over $10 billion dollars for care and prolonged hospitalization. Pressure ulcers can develop with as little as two hours of pressure, and because even a brief lapse in avoidance of pressure leads to ulcers, they are frequently impossible to prevent, even for the most conscientious patient with an extensive support group and unlimited financial resources. Therefore, enormous effort is required to find effective and reliable techniques for preventing the initiation of ulcers and eliminating them once they develop. This review looks at the various approaches presently used and in development for the treatment of pressure ulcers, evaluates which may be best in eliminating ulcers, and discusses combinations of techniques that may be most effective in eliminating pressure ulcers.

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Section: Electrical Stimulationmentioning

confidence: 99%

Techniques for Wound Healing with a Focus on Pressure Ulcers Elimination

Kuffler¹

2012

TOCVJ

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“…In vivo application of EFs appears to modulate corneal epithelial wound healing (Song et al ., 2002, 2004; Reid et al ., 2005). Importantly, electric stimulation has been approved for the treatment of some refractory skin wounds (Olyaee Manesh et al ., 2006). …”

Section: Introductionmentioning

confidence: 99%

Effects of Physiological Electric Fields on Migration of Human Dermal Fibroblasts

Guo

Song

Reid

et al. 2010

Journal of Investigative Dermatology

170

147

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Endogenous electric currents generated instantly at skin wounds direct migration of epithelial cells and are likely to be important in wound healing. Migration of fibroblasts is critical in wound healing. It remains unclear how wound electric fields guide migration of dermal fibroblasts. We report here that mouse skin wounds generated endogenous electric currents for many hours. Human dermal fibroblasts of both primary and cell-line cultures migrated directionally but slowly toward the anode in an electric field of 50–100 mV mm−1. This is different from keratinocytes, which migrate quickly to the cathode. It took more than 1 hour for dermal fibroblasts to manifest detectable directional migration. Larger field strength (400 mV mm−1) was required to induce directional migration within 1 hour after onset of the field. Phosphatidylinositol-3-OH kinase (PI3 kinase) mediates cathode-directed migration of keratinocytes. We tested the role of PI3 kinase in anode-directed migration of fibroblasts. An applied electric field activated PI3 kinase/Akt in dermal fibroblasts. Dermal fibroblasts from p110γ (a PI3 kinase catalytic subunit) null mice showed significantly decreased directional migration. These results suggest that physiological electric fields may regulate motility of dermal fibroblasts and keratinocytes differently, albeit using similar PI3 kinase-dependent mechanisms.

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“…Three reviews included trials that evaluated interventions for two different wound types and included venous ulcer/ulcer unspecified, diabetic ulcer/ulcer unspecified, and venous ulcer/mixed venous and arterial ulcer trials, respectively . The remaining five reviews included trials that evaluated interventions for three to 10 different wound types and included between two and 19 trials, although the title of one of these reviews suggested that it only included arterial ulcers.…”

Section: Resultsmentioning

confidence: 99%

“…We selected the reviews independently from whether patients in the included trials had only a single type or multiple types of wounds. The search strategy and eligibility criteria of the reviews have been described in these Cochrane reviews . We considered only the main paper as indicated in the Cochrane reviews.…”

Section: Methodsmentioning

confidence: 99%

Dealing with heterogeneous populations in randomized wound trials: Challenges and potential solutions

Vollenweider

Ebneter

Mayer

et al. 2012

Wound Repair Regeneration

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Chronic wounds have a great variety of etiologies and manifestations that influence wound healing. Such heterogeneity potentially threatens the validity and clinical usefulness of trials if not considered appropriately. In 82 randomized wound trials retrieved from 10 Cochrane reviews, we assessed if and how authors considered wound and other prognostically important characteristics in the conduct and analysis of wound trials. We assessed whether these characteristics were discussed, reflected in the eligibility criteria, used for prestratification or for adjustments to ensure comparability of treatment groups, and whether subgroup analyses were conducted to identify heterogeneity of treatment effects. Nine percent of all trials explicitly discussed characteristics that influence wound healing in the introduction and 43% in the Discussion section. Ninety percent of trials had at least one prognostically important characteristic as eligibility criterion. Only 11% of trials used prestratification, and 6% adjusted the results for imbalances between treatment groups. Twenty-seven percent performed subgroup analyses with prognostically important characteristics defining subgroups. Chronic wound trials use simple randomization, but rarely adapt the study design and analysis to take the heterogeneity of patients into consideration. Collaborative multicenter trials would overcome many of the limitations and provide statistical power to detect important treatment effects both overall and in subgroups.

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Electromagnetic therapy for treating pressure ulcers

Cited by 14 publications

References 6 publications

Techniques for Wound Healing with a Focus on Pressure Ulcers Elimination

Techniques for Wound Healing with a Focus on Pressure Ulcers Elimination

Effects of Physiological Electric Fields on Migration of Human Dermal Fibroblasts

Dealing with heterogeneous populations in randomized wound trials: Challenges and potential solutions

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