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      Is Open Access

      Electrical stimulation to accelerate wound healing

      review-article

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          Abstract

          Background

          There are several applications of electrical stimulation described in medical literature to accelerate wound healing and improve cutaneous perfusion. This is a simple technique that could be incorporated as an adjunctive therapy in plastic surgery. The objective of this review was to evaluate the results of randomized clinical trials that use electrical stimulation for wound healing.

          Method

          We identified 21 randomized clinical trials that used electrical stimulation for wound healing. We did not include five studies with treatment groups with less than eight subjects.

          Results

          Electrical stimulation was associated with faster wound area reduction or a higher proportion of wounds that healed in 14 out of 16 wound randomized clinical trials. The type of electrical stimulation, waveform, and duration of therapy vary in the literature.

          Conclusion

          Electrical stimulation has been shown to accelerate wound healing and increase cutaneous perfusion in human studies. Electrical stimulation is an adjunctive therapy that is underutilized in plastic surgery and could improve flap and graft survival, accelerate postoperative recovery, and decrease necrosis following foot reconstruction.

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          Most cited references64

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          Electrical signals control wound healing through phosphatidylinositol-3-OH kinase-gamma and PTEN.

          Wound healing is essential for maintaining the integrity of multicellular organisms. In every species studied, disruption of an epithelial layer instantaneously generates endogenous electric fields, which have been proposed to be important in wound healing. The identity of signalling pathways that guide both cell migration to electric cues and electric-field-induced wound healing have not been elucidated at a genetic level. Here we show that electric fields, of a strength equal to those detected endogenously, direct cell migration during wound healing as a prime directional cue. Manipulation of endogenous wound electric fields affects wound healing in vivo. Electric stimulation triggers activation of Src and inositol-phospholipid signalling, which polarizes in the direction of cell migration. Notably, genetic disruption of phosphatidylinositol-3-OH kinase-gamma (PI(3)Kgamma) decreases electric-field-induced signalling and abolishes directed movements of healing epithelium in response to electric signals. Deletion of the tumour suppressor phosphatase and tensin homolog (PTEN) enhances signalling and electrotactic responses. These data identify genes essential for electrical-signal-induced wound healing and show that PI(3)Kgamma and PTEN control electrotaxis.
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            Electrical controls of development.

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              Human skin battery potentials and their possible role in wound healing.

              Measurements of transcutaneous voltage have been made on seventeen normal volunteers. The results show the presence of 'skin battery' voltages comparable in size to those previously reported for amphibian and mammalian skin. No correlation was found between battery voltage and age or sex in the group studied, but consistent anatomical variations were observed. The possible role of these voltages in the natural wound healing process is discussed.
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                Author and article information

                Journal
                Diabet Foot Ankle
                Diabet Foot Ankle
                DFA
                Diabetic Foot & Ankle
                Co-Action Publishing
                2000-625X
                16 September 2013
                2013
                : 4
                : 10.3402/dfa.v4i0.22081
                Affiliations
                [1 ]Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA
                [2 ]Department of Surgery, University of Arizona, Tucson, AZ, USA
                [3 ]Department of Medicine, Diabetic Foot and Wound Center, Hamad Medical Corporation, Doha, Qatar
                [4 ]Department of Plastic Surgery, Georgetown University, Washington, DC, USA
                Author notes
                [* ] Lawrence A. Lavery, Department of Plastic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA. Tel: 214-648-3111. Email: Larry.Lavery@ 123456utsouthwestern.edu
                Article
                22081
                10.3402/dfa.v4i0.22081
                3776323
                24049559
                3770c738-a285-4763-8174-25279f4e10a7
                © 2013 Gaurav Thakral et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 July 2013
                : 11 August 2013
                : 21 August 2013
                Categories
                Review Article

                Endocrinology & Diabetes
                diabetic foot ulcer,electric stimulation therapy,treatment outcome,perfusion,infection

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