Electroceutical therapy to manage complex leg ulcers: a case series of three patients

Venous leg ulcers (VLUs) are estimated to affect around one in 500 people in the UK. They become much more common with age and it is estimated that around two per 100 people over the age of 80 have a VLU (NHS Choices, 2014). The average time taken for a VLU to heal is 6–9 months (Briggs and Clos, 2003), with 60% present for longer than 6 months, 33% present over a 1 year (Harrison et al, 2001) and 20% present for more than 5 years (Price and Harding, 1996). Guest et al (2013) suggested that 90% of VLUs remained unhealed at 6 months and that accepted best practice (compression bandaging) is not always successful at healing VLUs. Factors that contribute to a VLU being a complex poorly healing wound include: Comorbidities such as diabetes and rheumatoid arthritis, which affects small vessels Lifestyle, such as drug/alcohol abuse and smoking (Milic et al, 2009; Wigstone et al, 2013) Multiple medications (Wigstone et al, 2013) Age and non-concordance (Moffatt et al, 2009) Infection (Hurlow and Bowler, 2012) Pain (Cole-King and Harding, 2001, Broadhurst et al, 2003 ). Depression and/or social isolation and seasonal changes also contribute to VLUs not healing (Simka, 2010). Opportunities are therefore open to innovative treatments and advanced modalities such as electroceuticals to improve healing outcomes. One of such electroceuticals is Accel-Heal, a class IIA medical device. It is a 12day treatment course, consisting of six 48-hour single-use units delivering a sequence of electric current through electrode pads placed on healthy skin either side of the VLU, which has been demonstrated to be effective in wound healing (Tadej et al, 2010; Taylor et al, 2011). The treatment is an adjunct treatment applied alongside the patient’s standard wound therapy regimen and can be used under compression bandage.