Temple University School of Podiatric Medicine Journal Review Club
Editor's note: This post is part of the Temple...
by Michel H.E. Hermans, MD
Most of us will treat wounds primarily with Western-medicine techniques and materials, though, occasionally a "side step" is made. MEBO Wound Ointment is a non-Western, botanical cream that is used in the Middle East and the Far East for the management of partial-thickness burns. Although the exact working mechanisms of the ointment are not known, results often are good and some Western physicians have adopted its use.
The Use of Acupuncture in the Treatment of Wounds
Acupuncture has been used experimentally in the care of chronic wounds as well as in burn care. Its principles, according to some, are based on a yin and yang balance and according to others, on reflex systems. Some positive results have been reported, but many have the tendency to assign any efficacy on a placebo effect, particularly since there is no anatomical substrate for the presumed working mechanisms of the acupuncture treatment.
A recent publication in Burns1 reports on an experiment with deep partial-thickness burns on the back of rats. Burnt rats were compared to a sham group of non-burnt rats and in both groups different types of acupuncture (or not) were used.
Pain scales, specially developed for rats2, were used to judge to what extent pain existed in the different animals. In addition, histological samples were taken from the burned and non-burned areas.
The results were interesting: rats that received acupuncture treatment clearly showed signs of less stress and less pain, as judged by their level of alertness, their appetite and whether there fecal elimination was normal or not. In addition, histopathology showed that the number of microvessels in the wounds of rats treated with acupuncture treatment was higher.
The authors conclude that acupuncture not only helped ease the pain but also contributed to faster wound healing via a stimulatory effect on angiogenesis. They felt that that clinical experiments should be conducted to determine the potential benefits in humans with burns.
Linking Western Medicine with Eastern Medicine in Wound Care
In earlier blogs I have made comments about OTC products that are sold with a series of carefully worded "claims" and disclaimers, usually in very small print. These products are different from the true non-Western medical techniques, some of which have been used for millennia and for which good results have been described in properly conducted clinical experiments.
I have also blogged before how even rodents can be influenced and biased by research or the type of researcher (i.e. male vs. female) and that, perhaps, could explain the pain relief in the rats if one believes that acupuncture is based on placebo effects.
However, the histopathological changes in these rats cannot be explained by bias, researcher's influence or a placebo effect: I do not see how individual cells can be impacted this way.
The point here: it is important to be critical with regard to accepting clinical data as guidance for one's practice. At the same time, there is not always a perfect anatomical of physiological explanation for a beneficial effect that we may observe: indeed, not everything can always be explained. Therefore, modalities such as acupuncture deserve extensive research: it may very well be that, not only politically, but also medically links between East and West could be, and should be, improved.
1. Abali AE, Cabioqlu T, Ozdemir H, Haberal M. Interactive effects of acupuncture on pain and distress in major burns: An experiment with rats. Burns. 2015 Jun;41(4):833-842.
2. French E, et al. Assessment of pain in laboratory animals. Contemp Top. 2000;39:85.
About the Author
Michel H.E. Hermans, MD, is an expert in wound care and related topics, trained in general surgery, trauma care and burn care in the Netherlands. He has more than 25 years of senior management experience in the wound care industry. He has conducted a large number of clinical trials relating to devices and drugs aimed at wound care and related indications and diseases. Dr. Hermans speaks internationally and has authored many published works relating to wound management.
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.