title: A randomized control study on the effect of biphasic electrical stimulation in a warm room on skin blood flow and healing rates in chronic wounds of patients with and without diabetes.
abstract: BACKGROUND
  Decrease in skin blood flow (BF) due to diabetes may be one reason why only 31% of neuropathic diabetic ulcers heal in 20-weeks. Recent evidence shows that skin blood flow may be increased if therapy is done in a warm room. The purpose of this investigation was to compare healing rates and skin blood flow of chronic stage III and IV wounds in people with diabetes (D) and those without diabetes (WD) using a warm room and electrical stimulation.
  
  
  METHODS
  Twenty subjects with chronic stage III and IV wounds were treated at an outpatient wound center. Ten were D, and ten were WD. Treatment consisted of biphasic electrical stimulation up to 20 ma for 30 minutes, 3 x week for 4 weeks in a 32 degrees C room. Skin blood flow was measured by a Laser Doppler Imager.
  
  
  RESULTS
  BF increased not only during the stimulation (the increase in BF was greater for D at 87% than WD at 6%) at the outside of the wound but even at rest before stimulation started after the initial treatment creating a carryover effect. There was no increase in skin blood flow in the center of the wound. Healing rates over four weeks of up to 70% were seen in subjects with diabetes using biphasic current.
  
  
  CONCLUSIONS
  Using stimulation in a warm room significantly increased healing and skin blood flow in these wounds.
authors.affiliation: Department of Physical Therapy, Loma Linda University, Loma Linda, CA 92350, USA.
authors.forename: Daryl
authors.initials: D
authors.lastname: Lawson
authors.forename: Jerrold S
authors.initials: JS
authors.lastname: Petrofsky
mesh_terms: D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000628:therapy*; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D012867:Skin / Q000098:blood supply*; D013696:Temperature; D013997:Time Factors; D014456:Ulcer / Q000150:complications / Q000473:pathology / Q000628:therapy; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000150:complications* / Q000473:pathology / Q000628:therapy*