Electrical stimulation of chronic wounds and pressure ulcers – from origins to the present day (review).



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Abstract

Healing of chronic wounds and pressure ulcers remains a current problem of surgery. Methods of their local treatment, despite the diversity, have some drawbacks.

Aim: to evaluate the effectiveness of electrical wound stimulation technology in patients with chronic wounds and pressure ulcers based on literature data.

Materials and methods. We used the international PubMed database to search and select relevant works. The use of electric current in medicine to improve the healing of various types of wounds has a long history. Based on literature data, we described the fundamental mechanisms of wound electrical stimulation are outlined, various options for the technique, its advantage. Also we carried out the analysis of the effectiveness of the technology, including in combination with other physical factors.

Conclusion: the technology of electrical stimulation of chronic wounds and pressure ulcers significantly improves the course of complicated wound process. The introduction of the latest devices has great clinical prospects. The best results are achievable with a combination of wound electrical stimulation with other physicochemical techniques.

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About the authors

Evgeny L. Altukhov

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Author for correspondence.
Email: altukhoff@list.ru
ORCID iD: 0000-0001-8306-2538
SPIN-code: 8150-3473

surgeon

Russian Federation, Moscow

Aleksandr M. Shulutko

I.M. Sechenov First Moscow State Medical University

Email: shulutko@mail.ru
ORCID iD: 0000-0002-8001-1601

MD, Dr. Sci. (Medicine), professor

Russian Federation, Moscow

Elkhan G. Osmanov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: mma-os@yandex.ru
ORCID iD: 0000-0003-1451-1015

MD, Dr. Sci. (Med.), professor

Russian Federation, Moscow

Alexey A. Yakovlev

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Email: ayakovlev@fnkcrr.ru
ORCID iD: 0000-0002-8482-1249
SPIN-code: 2783-9692

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Elena G. Gandibina

I.M. Sechenov First Moscow State Medical University

Email: alzas2007@rambler.ru
ORCID iD: 0000-0002-6765-5154
SPIN-code: 7590-2148

MD, Cand. Sci. (Medicine), associate professor

Russian Federation, Moscow

Yu. S Paskhalova

A.V.Vishnevsky Institute of Surgery of the Ministry of Health of the Russian Federation; People’s Friendship University of Russia

Email: 9057176757@mail.ru
ORCID iD: 0000-0003-1215-8035
SPIN-code: 5401-1879

канд. мед. наук, зав. отд-нием гнойной хирургии

Russian Federation, 117997, Russian Federation, Moscow, ul. Bol'shaia Serpukhovskaia, d. 27

Alexander A. Shaibak

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Email: shaybak@mail.ru
ORCID iD: 0000-0003-0087-1466
SPIN-code: 8544-5407

Head of the Department. branches

Russian Federation, Moscow

References

  1. Adamian AA, Gogia BS, Muradian RG. [Electrostimulation for wounds treatment]. Khirurgiia (Sofiia). 1998;(1):57–9.
  2. Cousin MI, editor. Раны и раневая инфекция: Руководство для врачей. М.; 1990. 592 p.
  3. Adamjan AA, Shloznikov BM, Muzykant LI. [Dynamics of clinical and morphological changes in a burn wound during electrical stimulation with pulsed current]. Hirurgija Zhurnal im. NI Pirogova. 1990;(9):77–81.
  4. Pshelenskaja AI. [Application of high-frequency electrical stimulation in the treatment of open wounds of the perineum and sacrococcygeal region: abstract of the dissertation of candidate of medical sciences]. М.; 2014. p. 24.
  5. Du Bois-Reymond EH. Vorläufiger Abriss einer Untersuchung über den sogenannten Froschstrom und über die elektromotorischen Fische. 1843.
  6. Robertson WA. Digby’s receipts. Ann Med Hist. 1925;7(3):216.
  7. Hunckler J, de Mel A. A current affair: electrotherapy in wound healing. J Multidiscip Healthc. 2017 Apr;Volume 10:179–94.
  8. Kloth LC. Electrical stimulation for wound healing: a review of evidence from in vitro studies, animal experiments, and clinical trials. Int J Low Extrem Wounds. 2005;4(1):23–44.
  9. Kambouris ME, Markogiannakis A, Arabatzis M, Manoussopoulos Y, Kantzanou M, Velegraki A. Wireless Electrostimulation: A New Approach in Combating Infection? Future Microbiol. 2017 Mar 20;12(3):255–65.
  10. Khouri C, Kotzki S, Roustit M, Blaise S, Gueyffier F, Cracowski JL. Hierarchical evaluation of electrical stimulation protocols for chronic wound healing: An effect size meta‐analysis. Wound Repair and Regeneration. 2017 Sep 8;25(5):883–91.
  11. Mil'kov BO, Smirskij OA. [The use of direct current in the treatment of purulent-necrotic processes]. Vesti hirurgii. 1986;(9):97–8.
  12. Anisimov AI, Afinogenov GE, Linnik SA. [Impact of direct electric current and wound washing in the complex treatment of chronic osteomyelitis]. Vestnik hirurgii im. II Grekova. 1988;140(6):138–9.
  13. Landa VA. [Experimental substantiation of the use of pulsed low-frequency electric current to stimulate reparative regeneration of bone tissue]. Ortopedija, travmatologija, protezirovanie. 1982;(2):52–7.
  14. Sinicyn LN, Razvozova EP. [The influence of electrical microcurrents on regeneration processes in skin wounds]. Ortopedija i travmatologija. 1986;(2):25–7.
  15. Tkachenko SS, Ruckij VV. [Electrical stimulation of osteoreparation]. Medicina. L.; 1989. 67 p.
  16. Adunsky A, Ohry A. Decubitus direct current treatment (DDCT) of pressure ulcers: Results of a randomized double-blinded placebo controlled study. Arch Gerontol Geriatr. 2005 Nov;41(3):261–9.
  17. Gogija BSh. [Local stimulation with pulsed electric current in the complex treatment of long-term non-healing and sluggishly granulating burn wounds: abstract of the dissertation of candidate of medical sciences]. М.; 1990. p. 19.
  18. Nishimura KY, Isseroff RR, Nuccitelli R. Human keratinocytes migrate to the negative pole in direct current electric fields comparable to those measured in mammalian wounds. J Cell Sci. 1996;109(1):199–207.
  19. Eberhardt A, Szczypiorski P, Korytowski G. Effect of transcutaneous electrostimulation on the cell composition of skin exudate. Acta Physiol Pol. 1986;37(1):41–6.
  20. Orida N, Feldman JD. Directional protrusive pseudopodial activity and motility in macrophages induced by extracellular electric fields. Cell Motil. 1982;2(3):243–55.
  21. Bourguignon G, Bergouignan M, Khorshed A, et al. Effect of high voltage pulsed galvanic stimulation on human fibroblasts in cell culture. J Cell Biol. 1986;103:344.
  22. Soong HK, PWC, SGL. Effects of electric fields on cytoskeleton of corneal stromal fibroblasts. Curr Eye Res. 1990;9(9):893–901.
  23. Maillard H. Une thérapie innovante des ulcères de jambe : l’électrostimulation. Ann Dermatol Venereol. 2015 Aug;142(8–9):493–7.
  24. Fang KS, Ionides E, Oster G, Nuccitelli R, Isseroff RR. Epidermal growth factor receptor relocalization and kinase activity are necessary for directional migration of keratinocytes in DC electric fields. J Cell Sci. 1999;112(12):1967–78.
  25. Abedin‐Do A, Zhang Z, Douville Y, Méthot M, Bernatchez J, Rouabhia M. Electrical stimulation promotes the wound‐healing properties of diabetic human skin fibroblasts. J Tissue Eng Regen Med. 2022 Jul 20;16(7):643–52.
  26. Sidzhanov BZh. [Morphological study of the wound process in purulent complications and their treatment with direct electric current]. In: Patologija sosudov i serdca. Alma-Ata; 1988. p. 223–4.
  27. Lagoumintzis G, Zagoriti Z, Jensen MS, Argyrakos T, Koutsojannis C, Poulas K. Wireless Direct Microampere Current in Wound Healing: Clinical and Immunohistological Data from Two Single Case Reports. Biosensors (Basel). 2019 Sep 5;9(3):107.
  28. Rowley BA, McKenna JM, Chase GR. The influence of electrical current on an infecting microorganism in wounds. 1974.
  29. Barranco SD, Spadaro JA, Berger TJ, Becker RO. In vitro effect of weak direct current on Staphylococcus aureus. Clin Orthop Relat Res. 1974;100:250–5.
  30. Laatsch-Lybeck LJ, Ong PC, Kloth LC. In vitro effects of two silver electrodes on select wound pathogens. Journal of Clinical Electrophysiology. 1995;
  31. Guffey JS, Asmussen MD. In vitro bactericidal effects of high voltage pulsed current versus direct current against Staphylococcus aureus. J Clin Electrophysiol. 1989;1(1):5.
  32. Szuminsky NJ, Albers AC, Unger P, Eddy JG. Effect of narrow, pulsed high voltages on bacterial viability. Phys Ther. 1994;74(7):660–7.
  33. Rowley BA, McKenna JM, Chase GR, Wolcott LE. The influence of electrical current on an infecting microorganism in wounds*. Ann N Y Acad Sci. 1974 Oct 16;238(1):543–51.
  34. CHU CS, McManus AT, Pruitt Jr BA, Mason Jr AD. Therapeutic effects of silver nylon dressings with weak direct current on pseudomonas aeruginosa-lnfected burn wounds. Journal of Trauma and Acute Care Surgery. 1988;28(10):1488–92.
  35. McLeod B, Dirckx P. The Center for Biofilm Engineering, Montana State University, Bozeman. Available from: URL: http//www. erc. montana. edu. Accessed January, 13. The combination of electricity plus antibiotic is more effective against biofilm cells than either is alone.
  36. Tirono M, Hananto FS, Abtokhi A. Pulse Voltage Electrical Stimulation for Bacterial Inactivation and Wound Healing in Mice with Diabetes. Avicenna J Med Biotechnol. 2022 Jan 1;
  37. Nair HKR. Microcurrent as an adjunct therapy to accelerate chronic wound healing and reduce patient pain. J Wound Care. 2018 May 2;27(5):296–306.
  38. Luo R, Dai J, Zhang J, Li Z. Accelerated Skin Wound Healing by Electrical Stimulation. Adv Healthc Mater. 2021 Aug 4;10(16).
  39. Yu C, Xu ZX, Hao YH, Gao YB, Yao BW, Zhang J, et al. A novel microcurrent dressing for wound healing in a rat skin defect model. Mil Med Res. 2019 Dec 23;6(1):22.
  40. Kloth LC. Electrical Stimulation Technologies for Wound Healing. Adv Wound Care (New Rochelle). 2014 Feb;3(2):81–90.
  41. Polak A, Kucio C, Kloth L, Paczula M, Hordynska E, Ickowicz T, et al. A Randomized, Controlled Clinical Study to Assess the Effect of Anodal and Cathodal Electrical Stimulation on Periwound Skin Blood Flow and Pressure Ulcer Size Reduction in Persons with Neurological Injuries. Ostomy Wound Management. 2018 Feb 15;64(2):10–29.
  42. Lokhvitskiĭ S V, Turgunov EM, Azizov IS, Kozhamberdin KE. [Electrostimulation therapy--a new method of preventing postoperative wound complications in abdominal surgery]. Vestn Khir Im I I Grek. 2002;161(3):11–5.
  43. Avrahami R, Rosenblum J, Gazes M, Rosenblum S, Litman L. The Effect of Combined Ultrasound and Electric Field Stimulation on Wound Healing in Chronic Ulcerations. Wounds. 2015 Jul;27(7):199–208.
  44. O’Connor T, Moore Z, Patton D, Wilson P, Gillen C, Hughes M, et al. Combined use of modulated ultrasound and electric current stimulation for diabetic foot ulcers: a case series. J Wound Care. 2017 Nov 2;26(11):632–40.
  45. Zhou K, Krug K, Stachura J, Niewczyk P, Ross M, Tutuska J, et al. Silver-Collagen Dressing and High-voltage, Pulsed-current Therapy for the Treatment of Chronic Full-thickness Wounds: A Case Series. Ostomy Wound Manage. 2016 Mar;62(3):36–44.
  46. You D, Li K, Guo W, Zhao G, Fu C.

    Poly (lactic-co-glycolic acid)/graphene oxide composites combined with electrical stimulation in wound healing: preparation and characterization

    . Int J Nanomedicine. 2019 Aug;Volume 14:7039–52.
  47. Palmieri B, Vadalà M, Laurino C. Electromedical devices in wound healing management: a narrative review. J Wound Care. 2020 Jul 2;29(7):408–18.
  48. Han C, Huang J, Zhangji A, Tong X, Yu K, Chen K, et al. Accelerated Skin Wound Healing Using Flexible Photovoltaic-Bioelectrode Electrical Stimulation. Micromachines (Basel). 2022 Mar 31;13(4):561.
  49. Zhao S, Mehta AS, Zhao M. Biomedical applications of electrical stimulation. Cellular and Molecular Life Sciences. 2020 Jul 23;77(14):2681–99.
  50. Zulbaran-Rojas A, Park C, El-Refaei N, Lepow B, Najafi B. Home-Based Electrical Stimulation to Accelerate Wound Healing—A Double-Blinded Randomized Control Trial. J Diabetes Sci Technol. 2023 Jan 30;17(1):15–24.
  51. Wang Y, Rouabhia M, Zhang Z. Pulsed electrical stimulation benefits wound healing by activating skin fibroblasts through the TGFβ1/ERK/NF-κB axis. Biochimica et Biophysica Acta (BBA) - General Subjects. 2016 Jul;1860(7):1551–9.
  52. Liu A, Long Y, Li J, Gu L, Karim A, Wang X, et al. Accelerated complete human skin architecture restoration after wounding by nanogenerator-driven electrostimulation. J Nanobiotechnology. 2021 Dec 20;19(1):280.
  53. Ruiz-Fernández AR, Campos L, Gutierrez-Maldonado SE, Núñez G, Villanelo F, Perez-Acle T. Nanosecond Pulsed Electric Field (nsPEF): Opening the Biotechnological Pandora’s Box. Int J Mol Sci. 2022 May 31;23(11):6158.
  54. Wang C, Jiang X, Kim HJ, Zhang S, Zhou X, Chen Y, et al. Flexible patch with printable and antibacterial conductive hydrogel electrodes for accelerated wound healing. Biomaterials. 2022 Jun;285:121479.
  55. Koel G, Houghton PE. Electrostimulation: Current Status, Strength of Evidence Guidelines, and Meta-Analysis. Adv Wound Care (New Rochelle). 2014 Feb;3(2):118–26.
  56. Arora M, Harvey LA, Glinsky J V, Nier L, Lavrencic L, Kifley A, et al. Electrical stimulation for treating pressure ulcers. Cochrane Database of Systematic Reviews. 2020 Jan 22;

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