Temple University School of Podiatric Medicine Journal Review Club
Article Title: Using the Entropic Wound Cycle as the Basic for Making Effective Treatment Choices
Authors: Mcguire, J, Sebag JA, Solnik, J
By Aletha Tippett MD
In 1771, Luigi Galvani discovered that the muscles of a frog leg contracted when touched by a spark. This spawned the beginning of our understanding of the relationship between electricity and electrical stimulation and its effect and use on the human body. One thing that is often overlooked when caring for wounds is the impact that electricity can have on wound healing. It is used in the form of electrical stimulation, most often applied by a physical therapist. In her wonderful book, Wound Care: A Collaborative Practice Manual for Health Professionals, Dr. Carrie Sussman provides the rationale and procedures for using electrical stimulation to promote wound healing.
Use of electrical stimulation to promote wound healing has been studied and reported for over 50 years. It is a therapy supported by the NPUAP and EPUAP since 2009. There are several types of waveforms to consider, including TENS (transcutaneous electrical nerve stimulation), HVPC (high-voltage pulsed current), NEMS (neuromuscular electrical stimulation) and LIDC (low intensity direct current, or low voltage pulsed current). A physical therapist would be a valuable consultant on using electrical stimulation for treating wounds. Electrical stimulation can be used for almost any wound type. It also promotes arterial circulation and inhibits infections.
One form of electrical current uses a high-voltage pulsed current that has shown great efficacy in treating wounds. In a recent retrospective study using a high-voltage pulsed current machine, MicroVas (manufactured by Microvas Technologies, Tulsa, OK), 88% of wounds in treated patients improved. This retrospective study was looking at using the high-voltage pulsed current to treat neuropathy. A total of 83% of patients with neuropathy improved their symptoms of pain or numbness and 36% had objective improvement with nerve conduction testing. Wounds were not treated directly by the HVPC, it was an adjunctive therapy. The improvement in wounds supports that this modality can be very useful. This report will be published in early 2014 in Wounds.
Based on the available evidence, wound care providers are encouraged to consider and use electrical stimulation to promote wound healing. A list of electrical stimulation devices can be found in Kestrel's WoundSource product reference under Biophysical Agents. Enroll a physical therapist to help with this treatment. Electrical stimulation for wound treatment is covered by Medicare, as long as certain criteria are met. This is a safe, non-invasive, proven treatment for wounds.
About The Author
Aletha Tippett MD is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, family physician, and international speaker on wound care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.