Bioelectronics

Collectively, the evidence supports a coherent scientific rationale for the application of exogenous EST to chronic hard-to-heal wounds.10 Indeed, significant clinical evidence for the beneficial effects of EST on chronic wounds has now accumulated11-13 across a range of different EST devices.

Amongst 40 hard-to-heal wounds recruited from three international sites, 78% of wounds displayed marked reductions in peri-wound oedema, inflammation, wound depth and area, that had not been seen during the preceding weeks of care in the same institutions. In these wounds, the clinical signs suggest the physiology of the wound had changed and that reparative process were in motion.

We demonstrated the working principle of this concept using culture models of skin wounds, and showed that EF guidance cues can increase the wound closure speed up to 3×, in comparison to non-stimulated controls.

"There is evidence that E-stim may impact on the healing of chronic wounds at a number of points in the healing process."

Antibacterial effects: Bacteria are a potent source of proinflammatory stimuli over a prolonged period, resulting in chronic inflammation and wound chronicity. For this reason, resolution of any bacterial imbalance is considered fundamental to the healing of chronic wounds (Schultz et al, 2003). Low-level E-stim has been shown in vitro to inhibit the growth of three organisms frequently isolated from chronic wounds — Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa (Kincaid and Lavoie, 1989).

Inflammation Modulation: Chronic inflammation needs to be resolved before functional granulation tissue is produced, and this process would be assisted by E-stim-driven recruitment of a normally functioning population of fresh macrophages (Moore, 1999).

Ordered Cellular Migration: Potential mode of action of E-stim on chronic wounds E-stim has been demonstrated to have potentially multiple effects on all phases of healing. One of the most marked cellular effects of E-stim demonstrated in the references cited above is the stimulation of directional cellular migration. This has particular therapeutic significance, as cell migration is required during each phase of healing.

In a meta-analysis of the effect of electrical stimulation on chronic wound healing, Gardner et al (1999) analysed the findings of 15 studies. Her conclusions state that, although further research is required to identify which E-stim devices are most effective, based on the average rates of healing E-stim increases the rate of chronic wound healing by 144%, thus inferring a positive effect on chronic wound healing.

This review evidences that electrical stimulation (ES) limits inflammation, increases wound blood perfusion, controls bacterial growth, increases fibroblast migration, induces angiogenesis, and encourages keratinocyte activity. This applies to both acute and chronic wounds. Additionally, electrical stimulation (notably pulsed current) significantly reduces the size of chronic wounds when compared to control groups with no ES.

Results from 22 well-designed randomized clinical trials and 10 high-quality SRs consistently support that EST can stimulate faster wound size reduction and/or produce a greater number of closed wounds compared to a group of similar patients receiving either standard wound care or sham EST.

Pooled results from well-conducted SRs provide strong support for the use of EST on various types of chronic wounds and pressure ulcers in particular.

These data show that treatment of muscle damage with Acustat electro-membrane microcurrent therapy reduces the severity of the symptoms. The mechanisms of action are unknown but are likely related to maintenance of intracellular Ca2 homeostasis after muscle damaging exercise.

Microcurrent stimulation to the body causes radically increased roduction of ATP levels. This allows the body to perform whatever healing process it has undertaken in an accelerated fashion.  

Using electric stimulation, researchers in a project at Chalmers University of Technology, Sweden, and the University of Freiburg, Germany, have developed a method that speeds up the healing process, making wounds heal three times faster.

Using a tiny engineered chip, the researchers were able to compare wound healing in artificial skin, stimulating one wound with electricity and letting one heal without electricity. The differences were striking.

The results of an analysis of I, 949 of these patients who listed pain

as their primary symptom and had used the device for a minimum of 3 weeks prior to mailing in the card are presented. With these self-reports of pain patients, the investigator determined that 93.02%

claimed significant pain reduction, ranging from a low of 81.82% in chronic regional pain syndrome patients to a high of98.31% and /00% in those suffering from migraine headaches and carpal tunnel syndrome, respectively.

Chang found that 500 microamperes caused adenosine triphosphate (ATP) to increase by 500% while raising the current over 5 milliamperes caused ATP to drop below baseline norms. Further, at 100-500 microamperes, amino acid transport rose 30-40% above controls.

During the four-week treatment period, all patients had a reduction in wound size, with 16 having complete wound closure. All 89 of the 100 patients who complained of pain, associated with their wound, experienced reduced pain scores, with 11 being pain-free at the end of the four-week period. There was significant reduction (p<0.001) in both mean pain score and mean wound area during the treatment period, as well as improvements in other parameters, such as reduction in inflammatory symptoms (leg swelling, foot stiffness), increased vasodilation (skin discolouration, leg heaviness, early morning erection, sensation), improvement in sleep quality, gait, and frequency of bowel movement. No adverse events were reported.