1
|
Szołtys-Brzezowska B, Bańkowska A, Piejko L, Zarzeczny R, Nawrat-Szołtysik A, Kloth LC, Polak A. Electrical Stimulation in the Treatment of Pressure Injuries: A Systematic Review of Clinical Trials. Adv Skin Wound Care 2023; 36:292-302. [PMID: 37212564 DOI: 10.1097/01.asw.0000926632.19578.b9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
GENERAL PURPOSE To provide information on evidence-based practice regarding the use of electrical stimulation for pressure injury management. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will:1. Apply clinical practice recommendations related to the use of electrical stimulation in the treatment of pressure injuries.2. Identify issues related to the use of electrical stimulation to treat pressure injuries.
Collapse
|
2
|
Girgis B, Carvalho D, Duarte JA. The effect of high-voltage monophasic pulsed current on diabetic ulcers and their potential pathophysiologic factors: A systematic review and meta-analysis. Wound Repair Regen 2023; 31:171-186. [PMID: 36507861 DOI: 10.1111/wrr.13063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/04/2022] [Accepted: 11/08/2022] [Indexed: 12/15/2022]
Abstract
The present review was conducted to determine the efficacy of high-voltage monophasic pulsed current (HVMPC) in treating diabetic ulcers, assess its effect on skin lesions with each of the pathophysiologic factors potentially contributing to diabetic ulcers, evaluate its safety, and identify treatment parameters. Electronic search of PubMed, Scopus, PEDro and Google Scholar databases was conducted. The revised tool for assessing risk of bias in randomised trials (RoB 2), the risk of bias in non-randomised studies-of interventions (ROBINS-I) and the Joanna Briggs Institute (JBI) critical appraisal tool were used to assess risk of bias and methodological quality. Overall quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principles. Thirty-two studies matched the eligibility criteria, and included 1061 patients with 1103 skin lesions of selected aetiologies; 12 randomised controlled trials were included in quantitative synthesis. HVMPC plus standard wound care (SWC) likely increased the probability of complete wound healing of pressure ulcers (PrUs) compared with sham/no stimulation plus SWC; relative risk (RR) 2.08; 95% CI: [1.42, 3.04], p = 0.0002; I2 = 0%, p = 0.61; eight studies, 358 ulcers. Although conclusive evidence regarding the effect of HVMPC on diabetic ulcers was not found, collateral evidence might suggest a potential benefit. Direct evidence, with moderate certainty, may support its efficacy in treating PrUs, albeit few adverse reactions were reported. Other observations, moreover, might indicate that this efficacy may not be limited to PrUs. Nonetheless, several aspects remain to be clarified for safe and effective application of electrical stimulation for wound healing.
Collapse
Affiliation(s)
- Beshoy Girgis
- CIAFEL, Faculty of Sport, University of Porto, Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar S. João, Faculty of Medicine, University of Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
| | | |
Collapse
|
3
|
Chen L, Ruan Y, Ma Y, Ge L, Han L. Effectiveness and safety of electrical stimulation for treating pressure ulcers: A systematic review and meta-analysis. Int J Nurs Pract 2022; 29:e13041. [PMID: 35244315 DOI: 10.1111/ijn.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/26/2021] [Accepted: 01/16/2022] [Indexed: 12/01/2022]
Abstract
AIM This study aims to synthesize qualitative evidence on the effectiveness and safety of electrical stimulation for treating pressure ulcers. BACKGROUND Electrical stimulation is often used clinically to treat pressure ulcers, but its effectiveness and safety and some potential problems are not clear. DESIGN This is a qualitative systematic review. DATA SOURCES The data sources are four English databases (PubMed, EMBASE, The Cochrane Library and Web of Science) and four Chinese databases (CNKI, SinoMed, VIP and WANFANG). METHODS Two reviewers independently examined the records according to the eligibility criteria and extracted the data of each included study. We used the Review Manager 5.3 software to perform data analysis. RESULTS Seventeen randomized controlled trials including 740 patients were included in this study. Meta-analysis of eight randomized controlled trials demonstrated that electrical stimulation significantly reduced the ulcer surface in contrast with standard wound care alone or pulsed sham electrical stimulation. Nine studies showed that electrical stimulation increased the risk of pressure ulcers being completely healed than the controlled group. Three studies reported that adverse reactions were rare. CONCLUSIONS This study demonstrated that electrical stimulation was a relatively effective and safe adjunctive therapy for pressure ulcers treatment.
Collapse
Affiliation(s)
- Lian Chen
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Yue Ruan
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Yuxia Ma
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Long Ge
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Lin Han
- School of Nursing, Lanzhou University, Lanzhou, China.,Department of Nursing, Gansu Provincial Hospital, Lanzhou, China
| |
Collapse
|
4
|
Yoshikawa Y, Hiramatsu T, Sugimoto M, Uemura M, Mori Y, Ichibori R. Efficacy of Low-frequency Monophasic Pulsed Microcurrent Stimulation Therapy in Undermining Pressure Injury: A Double-blind Crossover-controlled Study. Prog Rehabil Med 2022; 7:20220045. [PMID: 36160025 PMCID: PMC9470497 DOI: 10.2490/prm.20220045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/09/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives: This double-blind crossover-controlled trial aimed to verify the effect of electrical
stimulation therapy on pressure injuries with undermining. Methods : In this trial, we compared the healing rates between a sham period and a treatment
period using monophasic pulsed microcurrent therapy. The participants were randomly
assigned to the sham or treatment group and received stimulation for 2 weeks. All the
participants, physical therapists, and researchers were blinded to the allocation. For
the main analysis, data on the effect of the intervention on changes in weekly healing
and contraction rates of the wound areas, including undermining, were analyzed based on
a two-period crossover study design. The intervention effect was estimated by examining
the mean treatment difference for each period using Wilcoxon’s signed-rank test. Results : The reduction of the entire wound area, including the undermining area, resulted in
significantly higher healing and contraction rates in the treatment group (overall wound
area reduction rate: contraction rate, P=0.008; period healing rate, P=0.002). Conclusions : Electrical stimulation therapy for pressure injuries, using conditions based on the
findings of an in vivo culture study, was effective in reducing the wound area.
Collapse
Affiliation(s)
| | | | - Masaharu Sugimoto
- Department of Physical therapy, Kobe Gakuin University (Retired), Kobe, Japan
| | - Mikiko Uemura
- Department of Health Science, Kansai University of Welfare Sciences, Kashiwara City, Japan
| | - Yuki Mori
- Department of Rehabilitation, Housenka Hospital, Ibaraki City, Japan
| | - Ryoko Ichibori
- Department of Dermatology, Housenka Hospital, Ibaraki City, Japan
| |
Collapse
|
5
|
Cheah YJ, Buyong MR, Mohd Yunus MH. Wound Healing with Electrical Stimulation Technologies: A Review. Polymers (Basel) 2021; 13:3790. [PMID: 34771347 PMCID: PMC8588136 DOI: 10.3390/polym13213790] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/16/2021] [Accepted: 10/29/2021] [Indexed: 01/22/2023] Open
Abstract
Electrical stimulation (ES) is an attractive field among clinicians in the topic of wound healing, which is common yet complicated and requires multidisciplinary approaches. The conventional dressing and skin graft showed no promise on complete wound closure. These urge the need for the exploration of electrical stimulation to supplement current wound care management. This review aims to provide an overview of electrical stimulation in wound healing. The mechanism of galvanotaxis related to wound repair will be reviewed at the cellular and molecular levels. Meanwhile, different modalities of externally applied electricity mimicking a physiologic electric field will be discussed and compared in vitro, in vivo, and clinically. With the emerging of tissue engineering and regenerative medicine, the integration of electroconductive biomaterials into modern miniaturised dressing is of interest and has become possible with the advancing understanding of smart biomaterials.
Collapse
Affiliation(s)
- Yt Jun Cheah
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56600, Malaysia;
| | - Muhamad Ramdzan Buyong
- Institute of Microengineering and Nanoelectronics, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia;
| | - Mohd Heikal Mohd Yunus
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56600, Malaysia;
| |
Collapse
|
6
|
Rajendran SB, Challen K, Wright KL, Hardy JG. Electrical Stimulation to Enhance Wound Healing. J Funct Biomater 2021; 12:40. [PMID: 34205317 PMCID: PMC8293212 DOI: 10.3390/jfb12020040] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 12/11/2022] Open
Abstract
Electrical stimulation (ES) can serve as a therapeutic modality accelerating the healing of wounds, particularly chronic wounds which have impaired healing due to complications from underlying pathology. This review explores how ES affects the cellular mechanisms of wound healing, and its effectiveness in treating acute and chronic wounds. Literature searches with no publication date restrictions were conducted using the Cochrane Library, Medline, Web of Science, Google Scholar and PubMed databases, and 30 full-text articles met the inclusion criteria. In vitro and in vivo experiments investigating the effect of ES on the general mechanisms of healing demonstrated increased epithelialization, fibroblast migration, and vascularity around wounds. Six in vitro studies demonstrated bactericidal effects upon exposure to alternating and pulsed current. Twelve randomized controlled trials (RCTs) investigated the effect of pulsed current on chronic wound healing. All reviewed RCTs demonstrated a larger reduction in wound size and increased healing rate when compared to control groups. In conclusion, ES therapy can contribute to improved chronic wound healing and potentially reduce the financial burden associated with wound management. However, the variations in the wound characteristics, patient demographics, and ES parameters used across studies present opportunities for systematic RCT studies in the future.
Collapse
Affiliation(s)
- Saranya B. Rajendran
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire LA1 4AT, UK;
| | - Kirsty Challen
- Emergency Department, Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Sharoe Green Lane, Preston, Lancashire PR2 9HT, UK;
| | - Karen L. Wright
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire LA1 4YG, UK
| | - John G. Hardy
- Department of Chemistry, Faculty of Science and Technology, Lancaster University, Lancaster, Lancashire LA1 4YB, UK
- Materials Science Institute, Lancaster University, Lancaster, Lancashire LA1 4YB, UK
| |
Collapse
|
7
|
Electric Stimulation as an Effective Adjunctive Therapy for Diabetic Foot Ulcer: A Meta-analysis of Randomized Controlled Trials. Adv Skin Wound Care 2020; 33:608-612. [DOI: 10.1097/01.asw.0000695784.82605.1e] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
Palmieri B, Vadalà M, Laurino C. Electromedical devices in wound healing management: a narrative review. J Wound Care 2020; 29:408-418. [PMID: 32654604 DOI: 10.12968/jowc.2020.29.7.408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Wound healing is the sum of physiological sequential steps, leading to skin restoration. However, in some conditions, such as diabetes, pressure ulcers (PU) and venous legs ulcers (VLU), healing is a major challenge and requires multiple strategies. In this context, some electromedical devices may accelerate and/or support wound healing, modulating the inflammatory, proliferation (granulation) and tissue-remodelling phases. This review describes some helpful electromedical devices including: ultrasonic-assisted wound debridement; electrotherapy; combined ultrasound and electric field stimulation; low-frequency pulsed electromagnetic fields; phototherapy (for example, laser therapy and light-emitting diode (LED) therapy); biophotonic therapies, and pressure therapies (for example, negative pressure wound therapy, and high pressure and intermittent pneumatic compression) The review focuses on the evidence-based medicine and adequate clinical trial design in relation to these devices.
Collapse
Affiliation(s)
- Beniamino Palmieri
- Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Via del Pozzo, 71, 41124, Modena, Italy.,Second Opinion Medical Network, Via Ciro Bisi, 125, Modena, Italy
| | - Maria Vadalà
- Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Via del Pozzo, 71, 41124, Modena, Italy.,Second Opinion Medical Network, Via Ciro Bisi, 125, Modena, Italy
| | - Carmen Laurino
- Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Via del Pozzo, 71, 41124, Modena, Italy.,Second Opinion Medical Network, Via Ciro Bisi, 125, Modena, Italy
| |
Collapse
|
9
|
Arora M, Harvey LA, Glinsky JV, Nier L, Lavrencic L, Kifley A, Cameron ID. Electrical stimulation for treating pressure ulcers. Cochrane Database Syst Rev 2020; 1:CD012196. [PMID: 31962369 PMCID: PMC6984413 DOI: 10.1002/14651858.cd012196.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Pressure ulcers (also known as pressure sores, decubitus ulcers or bedsores) are localised injuries to the skin or underlying tissue, or both. Pressure ulcers are a disabling consequence of immobility. Electrical stimulation (ES) is widely used for the treatment of pressure ulcers. However, it is not clear whether ES is effective. OBJECTIVES To determine the effects (benefits and harms) of electrical stimulation (ES) for treating pressure ulcers. SEARCH METHODS In July 2019 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. We did not impose any restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA We included published and unpublished randomised controlled trials (RCTs) comparing ES (plus standard care) with sham/no ES (plus standard care) for treating pressure ulcers. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, extracted data, and assessed risk of bias. We assessed the certainty of evidence using GRADE. MAIN RESULTS We included 20 studies with 913 participants. The mean age of participants ranged from 26 to 83 years; 50% were male. ES was administered for a median (interquartile range (IQR)) duration of five (4 to 8) hours per week. The chronicity of the pressure ulcers was variable, ranging from a mean of four days to more than 12 months. Most of the pressure ulcers were on the sacral and coccygeal region (30%), and most were stage III (45%). Half the studies were at risk of performance and detection bias, and 25% were at risk of attrition and selective reporting bias. Overall, the GRADE assessment of the certainty of evidence for outcomes was moderate to very low. Nineteen studies were conducted in four different settings, including rehabilitation and geriatric hospitals, medical centres, a residential care centre, and a community-based centre. ES probably increases the proportion of pressure ulcers healed compared with no ES (risk ratio (RR) 1.99, 95% confidence interval (CI) 1.39 to 2.85; I2 = 0%; 11 studies, 501 participants (512 pressure ulcers)). We downgraded the evidence to moderate certainty due to risk of bias. It is uncertain whether ES decreases pressure ulcer severity on a composite measure compared with no ES (mean difference (MD) -2.43, 95% CI -6.14 to 1.28; 1 study, 15 participants (15 pressure ulcers) and whether ES decreases the surface area of pressure ulcers when compared with no ES (12 studies; 494 participants (505 pressure ulcers)). Data for the surface area of pressure ulcers were not pooled because there was considerable statistical heterogeneity between studies (I2 = 96%) but the point estimates for the MD of each study ranged from -0.90 cm2 to 10.37 cm2. We downgraded the evidence to very low certainty due to risk of bias, inconsistency and imprecision. It is uncertain whether ES decreases the time to complete healing of pressure ulcers compared with no ES (hazard ratio (HR) 1.06, 95% CI 0.47 to 2.41; I2 = 0%; 2 studies, 55 participants (55 pressure ulcers)). We downgraded the evidence to very low certainty due to risk of bias, indirectness and imprecision. ES may be associated with an excess of, or difference in, adverse events (13 studies; 586 participants (602 pressure ulcers)). Data for adverse events were not pooled but the types of reported adverse events included skin redness, itchy skin, dizziness and delusions, deterioration of the pressure ulcer, limb amputation, and occasionally death. We downgraded the evidence to low certainty due to risk of selection and attrition bias and imprecision. ES probably increases the rate of pressure ulcer healing compared with no ES (MD 4.59% per week, 95% CI 3.49 to 5.69; I2 = 25%; 12 studies, 561 participants (613 pressure ulcers)). We downgraded the evidence to moderate certainty due to risk of bias. We did not find any studies that looked at quality of life, depression, or consumers' perception of treatment effectiveness. AUTHORS' CONCLUSIONS ES probably increases the proportion of pressure ulcers healed and the rate of pressure ulcer healing (moderate certainty evidence), but its effect on time to complete healing is uncertain compared with no ES (very low certainty evidence). It is also uncertain whether ES decreases the surface area of pressure ulcers. The evidence to date is insufficient to support the widespread use of ES for pressure ulcers outside of research. Future research needs to focus on large-scale trials to determine the effect of ES on all key outcomes.
Collapse
Affiliation(s)
- Mohit Arora
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | - Lisa A Harvey
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | - Joanne V Glinsky
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | - Lianne Nier
- Royal North Shore HospitalSpinal Cord Injury UnitWard 7E, Royal North Shore Hospital, Reserve Road, St LeonardsSydneyNSWAustralia2065
| | - Lucija Lavrencic
- Royal North Shore HospitalSpinal Cord Injury UnitWard 7E, Royal North Shore Hospital, Reserve Road, St LeonardsSydneyNSWAustralia2065
| | - Annette Kifley
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | - Ian D Cameron
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | | |
Collapse
|
10
|
Babamohamadi H, Ansari Z, Nobahar M, Mirmohammadkhani M. The effects of peppermint gel on prevention of pressure injury in hospitalized patients with head trauma in neurosurgical ICU: A double-blind randomized controlled trial. Complement Ther Med 2019; 47:102223. [PMID: 31780037 DOI: 10.1016/j.ctim.2019.102223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/14/2019] [Accepted: 10/17/2019] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the effect of peppermint gel on the prevention of pressure injuries in patients with head trauma admitted to neurosurgical intensive care units. DESIGN This double blind, randomized, controlled clinical trial study was conducted on 150 patients with head trauma admitted to the ICU. Using sealed envelopes, patients were assigned randomly into two intervention (n = 75) and control (n = 75) groups. SETTING The study was conducted in the ICUs of a university hospital and a general hospital in Shiraz, Iran. INTERVENTION The intervention group received peppermint gel three times a day up to 14 days during the skin care as a layer on the skin areas exposed to the risk of pressure injuries. The control group used a placebo gel. PRIMARY OUTCOMES The expected outcome in this study was the incidence of pressure injuries stage I, which once daily was evaluated by pairs of observers with the National Pressure Ulcer Advisory Panel. RESULTS The incidence rate of pressure injuries was 22.8% and 77% in the intervention and the control groups, respectively. The chi-square test result showed a significant deference between two groups (P < 0.001). Sacrum was the most common site for incidence of the pressure injuries. CONCLUSION The findings showed that the peppermint gel has a positive effect in the prevention of pressure injuries in the patients with head trauma admitted to ICUs. So, the use of this gel is suggested as an easy and low-cost method for prevention of pressure injuries in the patients admitted to ICUs.
Collapse
Affiliation(s)
- Hassan Babamohamadi
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.
| | - Zahra Ansari
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran, Iran.
| | - Monir Nobahar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran; Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Epidemiology and Statistics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
| |
Collapse
|
11
|
Souza AK, Souza TR, Siqueira das Neves LM, de Paula Marcondes Ferreira Leite G, Garcia SB, Roberto de Jesus Guirro R, Barbosa RI, Caldeira de Oliveira Guirro E. Effect of High Voltage Pulsed Current on the integration of total skin grafts in rats submitted to nicotine action. J Tissue Viability 2019; 28:161-166. [DOI: 10.1016/j.jtv.2019.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/14/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022]
|
12
|
High Voltage Monophasic Pulsed Current (HVMPC) for stage II-IV pressure ulcer healing. A systematic review and meta-analysis. J Tissue Viability 2018; 27:274-284. [DOI: 10.1016/j.jtv.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/07/2018] [Accepted: 08/10/2018] [Indexed: 01/02/2023]
|
13
|
Taradaj J, Shay B, Dymarek R, Sopel M, Walewicz K, Beeckman D, Schoonhoven L, Gefen A, Rosińczuk J. Effect of laser therapy on expression of angio- and fibrogenic factors, and cytokine concentrations during the healing process of human pressure ulcers. Int J Med Sci 2018; 15:1105-1112. [PMID: 30123047 PMCID: PMC6097266 DOI: 10.7150/ijms.25651] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/25/2018] [Indexed: 01/14/2023] Open
Abstract
Objective: To evaluate the effect of laser irradiation at different wavelengths on the expression of selected growth factors and inflammatory mediators at particular stages of the wound healing process. Methods: Sixty-seven patients were recruited, treated, and analyzed (group A - 940 nm: 17 patients; group B - 808 nm: 18 patients; group C - 658 nm: 16 patients; group D - sham therapy: 17 patients). Patients received a basic treatment, including repositioning and mobilization, air pressure mattress and bed support surfaces, wound cleansing and drug therapy. Additionally, patients received laser therapy once a day, 5 times a week for 1 month in use of a semiconductor lasers (GaAlAs) which emitted a continuous radiation emission at separate wavelengths of 940 nm (group A), 808 nm (group B) and 658 nm (group C). In group D (sham therapy), laser therapy was applied in the same manner, but the device was off during each session (only the applicator was switched on to scan pressure ulcers using none coherent red visible light). Results: The positive changes in the measured serum (IL-2, IL-6 and TNF-α) and wound tissue (TNF-α, VEGF and TGFβ1) parameters appeared to be connected only with the wavelength of 658 nm. The significant change in pro-inflammatory mediator levels [interleukin 2 (IL-2) with p=0.008 and interleukin 6 (IL-6) with p=0.016] was noticed after two weeks of laser therapy. In the other groups, the inflammation was also reduced, but the process was not as marked as in group C. Similarly, in the case of tumor necrosis factor (TNF-α) concentration, where after two weeks of treatment with irradiation at a wavelength of 658 nm, a rapid suppression was observed (p=0.001), whereas in the other groups, these results were much slower and not as obvious. Interestingly, again in the case of group C, the change in TNF-α concentration in wound tissue was most intensive (≈75% reduction), whereas the changes in other groups were not as obvious (≈50% reduction). After irradiation (658 nm), the VEGF expression increased significantly within the first two weeks, and then it decreased and maintained a stable level. In contrast, the TGFβ1 activity remained level, but always higher in comparison to other groups Conclusions: The effective healing of pressure ulcers is connected with laser irradiation at a wavelength of 658 nm. We believe that this effect is related to the inhibition of inflammatory processes in the wound and stimulation of angiogenesis and fibroblast proliferation at this specific radiation (based both on concentration of interleukins and TNF-α serum level and VEGF, TGFβ1, TNF-α activities in wound biopsies). Laser therapy at wavelengths of 940 and 808 nm does not significantly affect the above-mentioned repair processes, which explains its low effectiveness in the treatment of pressure ulcers.
Collapse
Affiliation(s)
- Jakub Taradaj
- Department of Physiotherapy Basics, Academy of Physical Education, 72B Mikolowska St, 40-065 Katowice, Poland.,College of Rehabilitation Sciences, University of Manitoba, McDermot Av, R106 - 771, Winnipeg, Canada
| | - Barbara Shay
- College of Rehabilitation Sciences, University of Manitoba, McDermot Av, R106 - 771, Winnipeg, Canada
| | - Robert Dymarek
- Department of Nervous System Diseases, Wroclaw Medical University, 5 Bartla St, 51-618, Wroclaw, Poland
| | - Mirosław Sopel
- Department of Nervous System Diseases, Wroclaw Medical University, 5 Bartla St, 51-618, Wroclaw, Poland
| | - Karolina Walewicz
- Faculty of Physiotherapy, Public Higher Medical Professional School, 68 Katowicka St, 45-060, Opole, Poland
| | - Dimitri Beeckman
- University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, De Pintelaan 185 5K3 B-9000, Ghent, Belgium
| | - Lisette Schoonhoven
- Faculty of Health Sciences, University of Southampton, University Rd SO17 1BJ, Southampton, United Kingdom
| | - Amit Gefen
- Department of Biomedical Engineering, Tel Aviv University, P.O. Box 39040, 6997801, Tel Aviv, Israel
| | - Joanna Rosińczuk
- Department of Nervous System Diseases, Wroclaw Medical University, 5 Bartla St, 51-618, Wroclaw, Poland
| |
Collapse
|