title: Shock wave therapy in wound healing.
abstract: BACKGROUND
  Recently, shock wave therapy has been investigated as an adjuvant therapy in the treatment of acute and chronic wounds. There are several devices with focused and unfocused shock waves that have been administered to a heterogenous group of wounds. Encouraging preclinical and clinical studies suggest that shock wave therapy may promote wound healing with little or no adverse events, prompting investigations into the mechanism of action and additional clinical trials.
  
  
  METHODS
  The peer-reviewed literature within the past 10 years was studied using an evidence-based approach.
  
  
  RESULTS
  Preclinical studies demonstrate that shock wave therapy affects cellular function and leads to the expression of several genes and elaboration of growth factors known to promote wound healing. Limited clinical trials are encouraging for the use of shock wave therapy in the treatment of acute and chronic wounds. Serious complications, including wound infections, bleeding, hematomas, seromas, and petechiae, have not been reported in the largest of these studies.
  
  
  CONCLUSIONS
  Shock wave therapy is an intriguing physical modality that may play an important role as an adjuvant therapy in wound healing. To date, there is no consensus on which wounds are most likely to benefit from shock wave therapy and what the optimal power, degree of focus, and frequency or number of cycles should be. Well-designed preclinical and clinical studies are necessary to better understand shock wave therapy in wound healing.
authors.affiliation: Boston, Mass.; and Tokyo, Japan From Harvard Medical School; the Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School; and the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Qureshi
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Ross
authors.forename: Rei
authors.initials: R
authors.lastname: Ogawa
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Orgill
mesh_terms: D000818:Animals; D003921:Diabetes Mellitus, Experimental / Q000503:physiopathology; D019317:Evidence-Based Medicine; D006085:Graft Survival / Q000502:physiology; D019220:High-Energy Shock Waves; D006801:Humans; D066298:In Vitro Techniques; D051379:Mice; D008815:Mice, Inbred Strains; D016032:Randomized Controlled Trials as Topic; D051381:Rats; D012867:Skin / Q000293:injuries / Q000503:physiopathology; D012883:Skin Ulcer / Q000503:physiopathology / Q000628:therapy; D017695:Soft Tissue Injuries / Q000503:physiopathology / Q000628:therapy; D013524:Surgical Flaps / Q000502:physiology; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000503:physiopathology / Q000628:therapy*