A new electrode design to improve outcomes in the treatment of chronic non-healing wounds in diabetes.
BACKGROUND
Chronic wounds are life-threatening in people with diabetes. Some studies show that electrical stimulation (ES) can help wounds heal, while others do not. But, ES is usually applied using a two-electrode system, where current distribution is greatest in the center line between the electrodes. In the present study, a three-electrode system (three-channel ES) was developed. Current dispersion on the skin and in the quadriceps muscle was compared between the conventional two-electrode and three-electrode systems in controls and tested for its ability to heal chronic wounds in people with diabetes.


METHODS
In controls, current was delivered via a biphasic sine wave at a frequency of 30 Hz and pulse width of 100 microseconds. Stimulation electrodes 5 cm x 5 cm and 5 cm x 10 cm were placed at 10 cm and 15 cm separation distances above the quadriceps muscle. Skin currents were measured using five pairs of surface electrodes positioned in five separate locations on the skin. Muscle currents were measured using three pairs of needle electrodes positioned in three different locations in the muscle belly. In chronic wounds in eight subjects with diabetes, stimulation was applied for 1 month, and healing and blood flow were measured.


RESULTS
Current during three-channel ES was dispersed more evenly and more deeply than with conventional two-channel ES (P < 0.05). In wounds, there was almost complete healing in 1 month, and current was uniform in the wound.


CONCLUSIONS
Three-channel ES is more effective than two-channel ES in terms of better current dispersion across the skin and penetration into tissue and will probably be better for wound healing.
Department of Physical Therapy, Loma Linda University, Loma Linda, California 92350, USA.
HyeJin
H
Suh
Jerrold
J
Petrofsky
Anne
A
Fish
Vivian
V
Hernandez
Enrique
E
Mendoza
Kelly
K
Collins
Tienning
T
Yang
Armia
A
Abdul
Jennifer
J
Batt
Daryl
D
Lawson
D000328:Adult; D048909:Diabetes Complications / Q000628:therapy*; D017719:Diabetic Foot / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D004867:Equipment Design; D006801:Humans; D008875:Middle Aged; D012016:Reference Values; D012867:Skin / Q000503:physiopathology; D012879:Skin Physiological Phenomena; D012885:Skinfold Thickness; D050151:Subcutaneous Fat / Q000033:anatomy & histology; D014945:Wound Healing; D014947:Wounds and Injuries / Q000628:therapy*