title: A study of HVPC as an adjunctive therapy in limb salvage for chronic diabetic wounds of the lower extremity.
abstract: Complex diabetic ulcers of the lower extremity can be slow to heal and may lead to amputation. A retrospective study was conducted to evaluate the effect of a form of electrical stimulation using high-voltage, pulsed current (HVPC) as an adjunct to a multidisciplinary approach to limb salvage for chronic diabetic wounds of the lower extremity. Data from 30 patients with diabetes (17 men, 13 women, mean age 65.8 +/- 12.6 years, mean HgbA1c level = 8.2 +/- 1.5, with varying comorbidities) and 45 wounds were reviewed. Mean wound duration before referral and treatment was 25.0 weeks (range 4.0 to 60.0) and the mean wound surface area was 7.8 cm2 (range 0.6 cm2 to 62.0 cm2). The majority (62.2%) of wounds were classified 1C, 2C, or 3D (University of Texas diabetic wound classifications). The mean number of treatments, administered two or three times a week, was 23.0 (range 6.0 to 65.0) and 35 wounds (77.8%) healed after a mean of 14.2 weeks (range 3.4 to 59.0). Of those, 31 remained healed at a mean follow-up of 39.8 weeks (range 11.1 to 84.3) and additional HVPC healed two of the four recurrences. These results suggest that HVPC is a useful addition to a multidisciplinary limb salvage management approach for complex lower extremity wounds. Further study is warranted to elucidate its role in this application.
authors.affiliation: Grant Wound Care, Columbus, OH, USA.
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Burdge
authors.forename: Jodi F
authors.initials: JF
authors.lastname: Hartman
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003131:Combined Modality Therapy; D017719:Diabetic Foot / Q000097:blood / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012189:Retrospective Studies; D017592:Skin Care / Q000379:methods; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014463:Ultrasonography; D014945:Wound Healing
chemical_list: D006442:Glycated Hemoglobin