title: The combined effect of a three-channel electrode delivery system with local heat on the healing of chronic wounds.
abstract: BACKGROUND
  Historically, electrical stimulation (ES) has been used as a treatment for wound care. However, some studies show wounds healing with ES, whereas others do not. Part of the difficulty can be resolved by using heat to help dilate blood vessels, but an inherent problem with ES is uneven currents across the wound due to the use of only two electrodes. Therefore, we designed and tested a multi-electrode ES device in combination with local warming of the wound in non-healing chronic ulcers.
  
  
  METHODS
  Eighteen subjects (mean +/- SD age, 35.7 +/- 21.3 years) with chronic ulcers (no healing for 26.1 +/- 24.6 months) received ES treatment three times a week for 4 weeks. A heat lamp was used before and during ES to keep the wound and area surrounding the wound warm (37 degrees C). ES was applied for 30 min with biphasic sine wave stimulation at a frequency of 30 Hz, pulse width of 250 micros, and current of about 20 mA. Skin blood flow (BF) in and around the wound was measured with a laser Doppler imager. Wound size was measured prior to each treatment.
  
  
  RESULTS
  Over the 1-month period, the mean wound area significantly decreased by 43.4 +/- 44.5% (P < 0.05), and wound volume decreased by 57.0 +/- 27.9% (P < 0.05). Skin BF significantly increased after application of ES and local heat (P < 0.05). The skin BF response decreased as time progressed and the wound healed.
  
  
  CONCLUSIONS
  Thus, in this pilot study, application of a three-channel ES system in combination with local heat is effective in the healing of non-healing chronic wounds. Future studies should examine a larger population with variables such as treatment duration, number of days, or length of treatment to optimize the effect of ES on healing of non-healing chronic wounds.
authors.affiliation: Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, California 92350, USA.
authors.forename: Hyejin
authors.initials: H
authors.lastname: Suh
authors.forename: Jerrold S
authors.initials: JS
authors.lastname: Petrofsky
authors.forename: Takkin
authors.initials: T
authors.lastname: Lo
authors.forename: Daryl
authors.initials: D
authors.lastname: Lawson
authors.forename: Tina
authors.initials: T
authors.lastname: Yu
authors.forename: Tiffany M
authors.initials: TM
authors.lastname: Pfeifer
authors.forename: Theresa
authors.initials: T
authors.lastname: Morawski
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001783:Blood Flow Velocity / Q000502:physiology; D002908:Chronic Disease / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D004566:Electrodes; D005260:Female; D016523:Foot Ulcer / Q000628:therapy*; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000502:physiology; D010865:Pilot Projects; D012039:Regional Blood Flow / Q000502:physiology; D012867:Skin / Q000098:blood supply; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*