The effect of Extracorporeal Shock Wave Therapy in the treatment of burn scars: A prospective, randomized, controlled trial

Aguilera-Sáez, Jorge; Santos, Bruce Patrik Dos; Serracanta, Jordi Franch; Monte-Soldado, Alejandra; Bosacoma, Pau; Rivas-Nicolls, Danilo; Barret, Juan P.

doi:10.1016/j.burns.2021.06.006

Cited by 3 publications

(18 citation statements)

References 12 publications

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“…The SWT group showed significantly greater good to excellent improvements in the patient and observer global assessment [86]. Aguilera-Saëz et al [87] found no significant differences in any of the Vancouver Scar Scale variables, comparing a group of burn patients treated with standard of care with a group additionally treated with SWT.…”

Section: Shockwave Therapymentioning

confidence: 97%

Mechanomodulation: Physical Treatment Modalities Employ Mechanotransduction to Improve Scarring

Daele

Meirte

Anthonissen

et al. 2022

EBJ

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Every year, surgical interventions, traumatic wounds, and burn injuries lead to over 80 million scars. These scars often lead to compromised skin function and can result in devastating disfigurement, permanent functional loss, psychosocial problems, and growth retardation. Today, a wide variety of nonsurgical scar management options exist, with only few of them being substantiated by evidence. The working mechanisms of physical anti-scarring modalities remained unclear for many years. Recent evidence underpinned the important role of mechanical forces in scar remodeling, especially the balance between matrix stiffness and cytoskeleton pre-stress. This perspective article aims to translate research findings at the cellular and molecular levels into working mechanisms of physical anti-scarring interventions. Mechanomodulation of scars applied with the right amplitude, frequency, and duration induces ECM remodeling and restores the ‘tensile’ homeostasis. Depending on the scar characteristics, specific (combinations of) non-invasive physical scar treatments are possible. Future studies should be aimed at investigating the dose-dependent effects of physical scar management to define proper guidelines for these interventions.

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Section: Shockwave Therapymentioning

confidence: 97%

Mechanomodulation: Physical Treatment Modalities Employ Mechanotransduction to Improve Scarring

Daele

Meirte

Anthonissen

et al. 2022

EBJ

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“…According to the Cochrane Collaboration's tool, seven RCTs reported the method of randomisation, 20,25,28,[30][31][32]35 and four of them reported the allocation concealment. 25,31,32,35 Sham ESWT was only applied in four studies. 20,25,30,31 Four studies stated blinding of both patients and evaluators.…”

Section: T a B L E 1 Study Design And Patient Characteristics Of Incl...mentioning

confidence: 99%

“…A power analysis was only performed in one study. 25 Six of the included studies used pain symptom of scars as outcome measure 25,[28][29][30][31]35 (Table 1). Three studies assessed pruritus at scar sites after the intervention in different groups.…”

Section: T a B L E 1 Study Design And Patient Characteristics Of Incl...mentioning

confidence: 99%

“…20,25,35 Four studies specifically reported the results of the Vancouver scar scale (VSS). 29,31,34,35 Four studies provided the scars' thickness or height to F I G U R E 1 PRISMA flow diagram and exclusion criteria compare the effects of ESWT + CRT versus CRT alone. 25,31,32,34 Furthermore, two studies assessed the indexes of transepidermal water loss (TEWL) and elasticity at the scars sites.…”

Section: T a B L E 1 Study Design And Patient Characteristics Of Incl...mentioning

confidence: 99%

“…Six of the nine included studies, involving 288 patients, compared the effects of ESWT + CRT with CRT alone on pain related to PBPS. 25,[28][29][30][31]35 The data included mean value and standard deviation of the pain score at scars, and the number of patients in ESWT + CRT group and CRT alone group. Since the pooled effect was highly heterogeneous (p = 0.006, I 2 = 69%) across studies, a random effect model was used and the result showed that the application of ESWT + CRT was more effective in relieving pain related to the pathological scars than CRT alone, which was statistically significant (SMD = À0.59, 95% CI: [À0.87 to À0.31], p < 0.0001) (Figure 3A).…”

Section: T a B L E 1 Study Design And Patient Characteristics Of Incl...mentioning

confidence: 99%

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Safety and efficacy of treating post‐burn pathological scars with extracorporeal shock wave therapy: A meta‐analysis of randomised controlled trials

Yang

Kang

Jiang

et al. 2022

Wound Repair Regeneration

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The clinical application of shockwave therapy has expanded to the treatment of pathological scars. The objective of this systematic review and meta‐analysis is to quantitatively evaluate the efficacy and safety of extracorporeal shockwave therapy combined with comprehensive rehabilitation therapy on post‐burn pathological scars compared to comprehensive rehabilitation therapy alone. The randomised controlled trials of extracorporeal shockwave therapy for post‐burn pathological scars published in English and Chinese languages before October 2021 were included. The methodological quality and risk of bias of the selected articles were assessed with the Cochrane Collaboration's ‘risk of bias’ tool. RevMan software was applied for data analysis. This is the first systematic review and meta‐analysis considering the effectiveness and safety of extracorporeal shockwave therapy on post‐burn pathological scars. And nine randomised controlled trials involving 422 patients were included in this meta‐analysis. The meta‐analysis results showed that, compared with comprehensive rehabilitation therapy alone, extracorporeal shockwave therapy combined with comprehensive rehabilitation therapy was more effective in relieving pain (standardized mean difference [SMD] = −0.59, 95% confidence interval [CI]: [−0.87 to −0.31], p < 0.0001) and pruritus related to pathological scars (SMD = −0.94; 95% CI: [−1.25 to −0.63], p = 0.004), improving scars' appearance (SMD = −1.78, 95% CI: [−3.37 to −0.19], p = 0.03) and elasticity (SMD = 0.25, 95% CI: [0.29–0.21], p < 0.00001), decreasing scars thickness (SMD = −0.13, 95% CI: [−0.25 to −0.01], p = 0.04) and promoting the maturation status of scars (SMD = −2.86, 95% CI: [−3.96 to −1.76], p < 0.00001). There were no reported serious adverse events during and after extracorporeal shockwave therapy in the included studies. Available data preliminarily suggested that the combination of extracorporeal shockwave therapy and comprehensive rehabilitation therapy had better therapeutic effect on post‐burn pathological scars than comprehensive rehabilitation therapy alone, without obvious side effects. However, further clinical well‐controlled randomised controlled trials are needed. Systematic review registration ID: PROSPERO CRD42022297573.

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Therapeutic implications of extracorporeal shock waves in burn wound healing

Wang,

Hua,

Tang

et al. 2024

Journal of Tissue Viability

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The effect of Extracorporeal Shock Wave Therapy in the treatment of burn scars: A prospective, randomized, controlled trial

Cited by 3 publications

References 12 publications

Mechanomodulation: Physical Treatment Modalities Employ Mechanotransduction to Improve Scarring

Mechanomodulation: Physical Treatment Modalities Employ Mechanotransduction to Improve Scarring

Safety and efficacy of treating post‐burn pathological scars with extracorporeal shock wave therapy: A meta‐analysis of randomised controlled trials

Therapeutic implications of extracorporeal shock waves in burn wound healing

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