Local therapy and treatment costs of chronic, venous leg ulcers with electrical stimulation (Dermapulse^®): A prospective, placebo controlled, double blind trial

Abstract

The purpose of our study was the evaluation of the therapeutic benefit and the economical profit of low-frequency pulsed current applied to therapy-resistant venous leg ulcers. We investigated 39 patients in a prospective, placebo-controlled, double blind study on the effect of low-frequency pulsed current (Dermapulse) on healing in chronic venous ulcers during a 4-month course of treatment. All patients had chronic venous ulcers. The following criteria were recorded: ulcer size, pain, capillary density, and transcutaneous oxygen partial pressure. In verum group 3, ulcers healed and ulcer area was reduced significantly. In placebo group two ulcers healed. Ulcer size was reduced significantly in each group (paired test), the difference of ulcer area reduction between the "verum" and the placebo group (unpaired test) was not significant. Capillary density in the ulcer increased in both groups. In verum group, electrical stimulation led to rapid and lasting reduction of pain (unpaired test, p=0.049). By means of the process calculation method for the subgroup of outpatients this treatment method was economically effective. Electrical stimulation seems to be a viable treatment option for therapy-resistant venous leg ulcers.

Harnessing the Electric Spark of Life to Cure Skin Wounds

“…In addition, the speed of epithelialization in the wound was noticeably increased. 7 Fibroblasts that were exposed to EF had receptor levels of transforming growth factor-b which were six times greater than those of control fibroblasts, and this may explain the increase in collagen synthesis. 3 Despite the variation in the directional response of fibroblasts reported by different studies, it seems highly probable that in the Figure 3.…”

“…proliferative phase of wound healing, endogenous EFs activate the production of ECM by fibroblasts and induce fibroblast migration to the cathode (wound centre). 7 Further studies are necessary to uncover whether differentiation of fibroblasts into myofibroblasts results in changes in the electrotactic response. Such effects could explain polarity changes in different phases of wound healing.…”

“…Numerous animal studies and clinical trials have provided evidence and mechanistic insights into the effectiveness of Electrical stimulation (ES) for wound healing. [3][4][5][6][7][8] Consequently, clinicians and scientists are becoming increasingly aware of the potential for electrical therapies, and new electrical devices have been introduced clinically. 7,8 Indeed, ES is the most effective treatment for long-term, nonhealing ulcers, and this has been adopted as a policy by the European Pressure Ulcer Advisory Panel (www.epuap.org) and the National Pressure Ulcer Advisory Panel, Washington DC (www.npuap.org/ resources.htm).…”

“…[3][4][5][6][7][8] Consequently, clinicians and scientists are becoming increasingly aware of the potential for electrical therapies, and new electrical devices have been introduced clinically. 7,8 Indeed, ES is the most effective treatment for long-term, nonhealing ulcers, and this has been adopted as a policy by the European Pressure Ulcer Advisory Panel (www.epuap.org) and the National Pressure Ulcer Advisory Panel, Washington DC (www.npuap.org/ resources.htm). In the United States, ES is now approved for payment by the Centers for Medicare and Medicaid Services for treating pressure ulcers and wounds that have not responded to standard wound treatment.…”

“…The hypothesis that wound repair is guided by electric signals is supported by three main lines of evidence: (1) Strong electric currents exist at wounds and are required for effective wound healing; [9][10][11][12][13] (2) inhibition of endogenous currents specifically impairs wound closure; 13,14 and (3) applying an exogenous electric current of physiological intensity can induce faster wound closure both in vitro and in vivo. [3][4][5][6][7][8]14 In this review, we have compiled the present knowledge on the effects that electric fields (EFs) have on the behavior of cells involved in the healing response, and we focus on the mechanistic understanding of how electric signals are sensed and transmitted within these cells to influence their physiological behavior. In addition, we explore the potential of interfering with EF signaling to enhance skin wound repair by highlighting the potential of dual therapies using pharmacological compounds that regulate phosphorylation signaling and ES of wounds.…”