Influence of burst TENS stimulation on the healing of Achilles tendon suture in man.
Retrograde or antidromic stimulation of the nociceptive C fibres is known to lead to the release of sensory neuropeptides Substance P (SP) and Calcitonin Gene-Related Peptide (CGRP) by the peripheral endings of these ultra-thin nerve fibres. These neuropeptides have, among others, a vasodilatory effect, which explains why they play a role in the healing of soft tissues. Burst TENS (Transcutaneous Electric Nerve Stimulation) is known to be most effective in influencing C fibre-evoked activity. This is why burst TENS was used in a randomised study as a stimulus for the healing of the sutured Achilles tendon in 10 patients, versus 10 others who received no stimulus. There was one drop-out in each group, so that 2 x 9 patients remained available for the study. A needle biopsy, performed after six weeks, showed no significant influence of burst TENS on the histological healing stage, as compared with a rat study. However, a semi-quantitative evaluation of the number of fibroblasts showed a significant advantage for the stimulated group: p = 0.007. This means that burst TENS might influence healing of Achilles tendon sutures in man. But above all, it means that a histochemical study of the influence of burst TENS on the release of substance P and CGRP, after suture of the Achilles tendon in man, would be worthwhile.
Burssens
Peter
P
Department of Orthopaedic Surgery and Physiotherapy, Department of Pathology, University Hospital Gent, Belgium. peter.burssens@pandora.be
Forsyth
Ramses
R
Steyaert
Adelheid
A
Van Ovost
Edwin
E
Praet
Marleen
M
Verdonk
René
R
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D001265:Athletic Injuries / Q000601:surgery*; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism / Q000494:pharmacology; D005260:Female; D005347:Fibroblasts; D006801:Humans; D008297:Male; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000502:physiology; D012421:Rupture / Q000601:surgery; D013373:Substance P / Q000378:metabolism / Q000494:pharmacology; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing
D013373:Substance P; D015740:Calcitonin Gene-Related Peptide