Mohammed Ashrafi1, Teresa Alonso-Rasgado2, Mohamed Baguneid3, Ardeshir Bayat1. 1. Plastic and Reconstructive Surgery Research, Centre for Dermatological Research, Institute of Inflammation and Repair, University of Manchester, Oxford Road, Manchester, M13 9PT, UK. 2. Bioengineering Group, School of Materials, University of Manchester, Oxford Road, Manchester, M13 9PT, UK. 3. Wythenshawe Hospital, University Hospital South Manchester NHS Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK.
Abstract
BACKGROUND: Complicated cutaneous wounds and their subsequent management can be a clinical challenge in veterinary medicine. There is still an unmet need for an ideal wound healing therapy that is able to stimulate efficiency and quality of repair. Skin wounds generate large and persistent endogenous electric currents and fields termed the "current of injury". The current of injury is involved in numerous processes of wound healing. These observations have led to the hypothesis that applied electrical stimulation (ES) may promote wound healing by imitating the natural electrical current that occurs in cutaneous wounds. OBJECTIVES: This review details the use, effect and mechanism of ES in different preclinical experimental cutaneous wound models and discusses the potential of how ES could be translated into veterinary practice. RESULTS: Studies have found a variable effect of ES on wound healing. Some have been positive with faster rates of wound re-epithelialization, increased wound collagen formation and angiogenesis noted. Other studies have shown no effect or detrimental results. The effects of ES are highly influenced by the ES modality, polarity and parameters. CONCLUSIONS AND CLINICAL IMPORTANCE: Electrical stimulation has the potential to play a significant role in enhancing cutaneous wound healing in veterinary practice. Clinical studies are necessary to corroborate the findings from experimental studies which have shown promise including the use of alternating pulsed and direct current and the use of bio-electric dressings. The ideal ES device would need to be safe, easy to use, portable, noninvasive and aid wound healing by having a beneficial effect on all wound healing stages.
BACKGROUND: Complicated cutaneous wounds and their subsequent management can be a clinical challenge in veterinary medicine. There is still an unmet need for an ideal wound healing therapy that is able to stimulate efficiency and quality of repair. Skin wounds generate large and persistent endogenous electric currents and fields termed the "current of injury". The current of injury is involved in numerous processes of wound healing. These observations have led to the hypothesis that applied electrical stimulation (ES) may promote wound healing by imitating the natural electrical current that occurs in cutaneous wounds. OBJECTIVES: This review details the use, effect and mechanism of ES in different preclinical experimental cutaneous wound models and discusses the potential of how ES could be translated into veterinary practice. RESULTS: Studies have found a variable effect of ES on wound healing. Some have been positive with faster rates of wound re-epithelialization, increased wound collagen formation and angiogenesis noted. Other studies have shown no effect or detrimental results. The effects of ES are highly influenced by the ES modality, polarity and parameters. CONCLUSIONS AND CLINICAL IMPORTANCE: Electrical stimulation has the potential to play a significant role in enhancing cutaneous wound healing in veterinary practice. Clinical studies are necessary to corroborate the findings from experimental studies which have shown promise including the use of alternating pulsed and direct current and the use of bio-electric dressings. The ideal ES device would need to be safe, easy to use, portable, noninvasive and aid wound healing by having a beneficial effect on all wound healing stages.
Authors: Sashwati Roy; Shaurya Prakash; Shomita S Mathew-Steiner; Piya Das Ghatak; Varun Lochab; Travis H Jones; Prashanth Mohana Sundaram; Gayle M Gordillo; Vish V Subramaniam; Chandan K Sen Journal: Adv Wound Care (New Rochelle) Date: 2019-04-03 Impact factor: 4.730