Transcutaneous Electrical Nerve Stimulation (TENS) Accelerates Cutaneous Wound Healing and Inhibits Pro-inflammatory Cytokines

Abstract

The purpose of this study was to evaluate transcutaneous electrical nerve stimulation (TENS) and other common treatment methods used in the process of wound healing in terms of the expression levels of pro-inflammatory cytokines. In the study, 24 female and 24 male adult Wistar-Albino rats were divided into five groups: (1) the non-wounded group having no incision wounds, (2) the control group having incision wounds, (3) the TENS (2 Hz, 15 min) group, (4) the physiological saline (PS) group and (5) the povidone iodine (PI) group. In the skin sections, interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were assessed with enzyme-linked immunosorbent assay and immunohistochemical methods. In the non-wounded group, the expression of IL-1β, IL-6, and TNF-α signaling molecules was weaker in the whole tissue; however, in the control group, significant inflammatory response occurred, and strong cytokine expression was observed in the dermis, granulation tissue, hair follicles, and sebaceous glands (P < 0.05). In the TENS group, the decrease in TNF-α, IL-1β, and IL-6 immunoreaction in the skin was significant compared to the other forms of treatment (P < 0.05). Distinctive decreases of pro-inflammatory cytokines observed in the dermis in the TENS group suggest that TENS shortened the healing process by inhibating the inflammation phase.

Feasibility of an electrostimulation system treatment for wound healing: a case series of patients with chronic ulcers in Barbados

“…Gürgen et al reported a significant decrease in the pro‐inflammatory cytokines interleukin‐1 beta (IL‐1β), interleukin‐6 (IL‐6) and tumour necrosis factor‐α (TNF‐α) in the dermis of rat wounds following treatment with transcutaneous electrical nerve stimulation (TENS), a form of ES, compared with other forms of treatment . Their findings suggested that this form of ES shortened the healing process by inhibiting the inflammation phase . On the other hand, studies have reported induced inflammation with ES treatment.…”

Effects of transcutaneous electrical nerve stimulation (TENS) on proinflammatory cytokines: protocol for systematic review

“…To identify the biochemical terms for the search, studies that addressed the subject of inflammatory cytokines will be consulted [20, 22, 31–34]. Keywords are selected according to Medical Subject Headings (MeSH) in the National Library of Medicine.…”

The efficacy of electrical stimulation in experimentally induced cutaneous wounds in animals

“…Application of transcutaneous electrical nerve stimulation (TENS) to incisional wounds in rats increased the rate of re‐epithelialization as compared to controls, when 40 mA was applied at a pulse frequency of 2 Hz for 15 min daily for 5 days . There was also a decrease in the expression of the pro‐inflammatory cytokines interleukin‐1 beta, interleukin‐6 and tumour necrosis factor‐alpha in the electrically stimulated group compared to wounded controls.…”

“…There was also a decrease in the expression of the pro‐inflammatory cytokines interleukin‐1 beta, interleukin‐6 and tumour necrosis factor‐alpha in the electrically stimulated group compared to wounded controls. The authors concluded that electrical stimulation shortened the wound healing process by inhibiting the inflammatory phase. Pulsed current has been shown to have a positive outcome on wound closure; however, this is highly dependent on current intensity, polarity switch and duration of stimulation.…”