Electrical Stimulation And Wound Healing References

Evidence is reviewed (8 studies involving 215 clinical patients with ischemic skin ulcers and 7 animal tissue or tissue culture studies) that electrical stimulation of fibroblast cells accelerates the intracellular biosynthesis necessary to form new granulation tissue in a healing wound, and that both a direct local tissue effect and a circulatory improvement occur. A model is presented in which transmembrane currents open voltage-controlled calcium channels in fibroblast cells, causing ATP resynthesis, activation of protein kinase mechanisms to synthesize new cellular protein, and the DNA replication necessary for mitotic cell division. Stimulation efficacy appears to be determined by a number of basic electrical parameters, and judicious waveform control is desirable Black J. (1985) Electrical stimulation of hard and soft tissues in animal models. Clin. Plast. Surg. 12, 243-257. Abstract: Studies in animals have clearly established that various forms of electrical stimulation positively affect the growth, repair, and remodeling of hard and soft tissue. Although the various electrical stimulation modalities (faradic, capacitive, and inductive) are different in their physics and biochemistry, each produces a variety of biological responses in a wide range of animal models. The level of interest in animal studies of electrical stimulation is rising rapidly, and new understanding, in parallel with studies in vitro and in the clinic, will continue to be gained. The future holds the promise of a wide range of hard and soft tissue conditions being routinely treated by electrical stimulation, based in part on progress in studies in animals Bogie K.M., Reger S.I., Levine S.P., and Sahgal V. (2000) Electrical stimulation for pressure sore prevention and wound healing. Assist. Technol. 12, 50-66. Abstract: This paper reviews applications of therapeutic electrical stimulation (ES) specific to wound healing and pressure sore prevention. The application of ES for wound healing has been found to increase the rate of healing by more than 50%. Furthermore, the total number of wounds healed is also increased. However, optimal delivery techniques for ES therapy have not been established to date. A study of stimulation current effects on wound healing in a pig model has shown that direct current (DC) stimulation is most effective in wound area reduction and alternating current (AC) stimulation for wound volume reduction at current densities of 127 microA/cm2 and 1,125 microA/cm2, respectively. Preliminary studies have been carried out at two research centers to assess the role of ES in pressure sore prevention. Surface stimulation studies have shown that ES can produce positive short-term changes in tissue health variables such as regional blood flow and pressure distribution. The use of an implanted stimulation system consisting of intramuscular electrodes with percutaneous leads has been found to produce additional long-term changes. Specifically, gluteal muscle thickness increased by 50% with regular long-term ES application concurrent with a 20% decrease in regional interface pressures and increased tissue oxygen levels. These findings indicate that an implantable ES system may have great potential for pressure sore prevention, particularly for individuals who lack sensation or who are physically unable to perform regular independent pressure relief Bogie K.M., Reger S.I., Levine S.P., and Sahgal V. (2000) Electrical stimulation for pressure sore prevention and wound healing. Assist. Technol. 12, 50-66. Abstract: This paper reviews applications of therapeutic electrical stimulation (ES) specific to wound healing and pressure sore prevention. The application of ES for wound healing has been found to increase the rate of healing by more than 50%. Furthermore, the total number of wounds healed is also increased. However, optimal delivery techniques for ES therapy have not been established to date. A study of stimulation current effects on wound healing in a pig model has shown that direct current (DC) stimulation is most effective in wound area reduction and alternating current (AC) stimulation for wound volume reduction at current densities of 127 microA/cm2 and 1,125 microA/cm2, respectively. Preliminary studies have been carried out at two research centers to assess the role of ES in pressure sore prevention. Surface stimulation studies have shown that ES can produce positive short-term changes in tissue health variables such as regional blood flow and pressure distribution. The use of an implanted stimulation system consisting of intramuscular electrodes with percutaneous leads has been found to produce additional long-term changes. Specifically, gluteal muscle thickness increased by 50% with regular long-term ES application concurrent with a 20% decrease in regional interface pressures and increased tissue oxygen levels. These findings indicate that an implantable ES system may have great potential for pressure sore prevention, particularly for individuals who lack sensation or who are physically unable to perform regular independent pressure relief Braddock M., Campbell C.J., and Zuder D. (1999) Current therapies for wound healing: electrical stimulation, biological therapeutics, and the potential for gene therapy. Int. J. Dermatol. 38, 808-817. Branham G.B., Triplett R.G., Yeandle S., and Vieras F. (1985) The effect of electrical current on the healing of mandibular freezedried bone allografts in dogs. J. Oral Maxillofac. Surg. 43, 403-407. Abstract: Low levels of electrical current have been shown to affect the process of osseous repair. This study experimentally evaluated the effect of electrical stimulation on the healing of freeze-dried mandibular allogeneic bone grafts in dogs. Healing of the grafts was monitored by sequential submento-occlusal radiographs and radionuclide bone imaging at two, four, six, and eight weeks after grafting. Results indicated no significant difference in the osseous repair of stimulated and nonstimulated freeze-dried allogeneic bone grafts Brighton C.T., Hozack W.J., Brager M.D., Windsor R.E., Pollack S.R., Vreslovic E.J., and Kotwick J.E. (1985) Fracture healing in the rabbit fibula when subjected to various capacitively coupled electrical fields. J. Orthop. Res. 3, 331-340. Abstract: The effect of capacitively coupled electrical stimulation on the healing of midshaft transverse osteotomies of the rabbit fibula is assessed roentgenographically, mechanically, and histologically. The results show that a dose-response curve for capacitive coupling and fracture healing exists and that a 220 mV, 250 microA, 60 kHz applied electrical signal (0.33 V/cm internal electric field) is the most effective signal for fracture stimulation in this model Brondbo K., Jacobsen E., Gjellan M., and Refsum H. (1992) Recurrent nerve/ansa cervicalis nerve anastomosis: a treatment alternative in unilateral recurrent nerve paralysis. Acta Otolaryngol. 112, 353-357. Abstract: Sectioning of the right recurrent nerve was done in 5 mongrel dogs under general anaesthesia. The distal stump was anastomosed with the ansa cervicalis nerve branch to the sternothyroid muscle. Three to 5 months later the vocal cord movements during light and very light anaesthesia were videorecorded. Under light anaesthesia contraction and medial bulging of the reinnervated right vocal cord occurred in 4 of the dogs. Under very light anaesthesia there was also some adduction of the right vocal cord in these 4 dogs. The right recurrent nerve was then sectioned proximally to the anastomosis and stimulated electrically. In all 5 dogs we observed that electrical stimulation produced a strong adduction of the right vocal cord. Histochemistry of the right vocal and posterior cricoarytenoid muscles showed that reinnervation had taken place. The study indicates that in cases of unilateral vocal cord paralysis an anastomosis between the ansa cervalalis and the recurrent nerve will result in improved phonatory function of the