CLOSED LAVAGE, ELECTRICAL STIMULATION
Acute wounds normally undergo a complex healing process, which ultimately leads to a completely healed wound [1]. The process of acute wound healing is typically divided into a series of overlapping phases, which include: haemostasis, inflammation, proliferation, wound contraction and remodeling [2]. Normal would healing in the skin should result in the restoration of skin continuity and function. Nevertheless, there are a number of responses which can occur following a cutaneous injury; normal repair in the adult human skin should typically produce a fine line permanent scar, however, abnormal healing can result in excessive healing where there is an increased deposition of connective tissue leading to the formation of hypertrophic and keloid scars or either can deficient healing where there is insufficient deposition of connective tissue and therefore, new tissue formation is incomplete and can result in the formation of chronic wounds.
Electrical stimulation (ES), in the form of alternating current (AC), direct current (DC) and pulsed current (PC), has been shown to have beneficial effects on cutaneous wound healing in chronic wounds. When ES is applied to a chronic wound, this produces beneficial effects throughout the three phases of wound healing: inflammation, proliferation and remodelling phases. Inflammatory phase: ES increases blood flow, tissue oxygenation and stimulates fibroblasts whilst reducing oedema and providing an increased antibacterial effect. Proliferative phase: ES increases membrane transport, collagen matrix organization, wound contraction and the stimulation of DNA and protein synthesis. Remodelling phase: ES increases epidermal cell proliferation, and migration as well as stimulation of fibroblasts thus enabling enhanced wound closure.
Electrical stimulation (ES), in the form of biofeedback ES, direct current (DC) and pulsed current (PC), has been shown to have beneficial effects on cutaneous wound healing in acute wounds. When ES is applied to an acute wound, this produces beneficial effects throughout the three phases of wound healing: inflammation, proliferation and remodelling phases. Inflammatory phase: ES increases blood flow, skin temperature and vasodilation. Proliferative phase: ES increases keratinocyte proliferation and wound contraction. Remodeling phase: ES advances the remodelling face and increases re-epithelialisation enabling enhanced wound healing.
The current of injury is thought to be significant in initiating repair. Undamaged human skin has an endogenous electrical potential and a transcutaneous current potential of 20–50 mV. This is generated by the movement of sodium ions through Na+/K+ ATPase pumps in the epidermis. The current of injury is generated through epithelial disruption. Following an injury to the skin, a flow of current through the wound pathway generates a lateral electrical field and this is termed the “current of injury” or “skin battery” effect.
Therapeutic Effects
- Evidence based wound treatment for difficult to heal or chronic wounds
- Offered to patients in the own home or assisted living facility
- Time tested, heavily researched intervention
- Painless treatment
- Supplement to existing topical agents and dressings
- Typical wound healing rate of 38-45% per week noted
- No adverse effects
- Research indicates statistically significant wound healing versus controls with pressure ulcers, venous stasis ulcers and infected wounds
- Enhances “Skin Battery Effect” essential to wound healing