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      Radiofrecuencia en la cicatrización de heridas crónicas. Una revisión en hospital de media estancia Translated title: Radiofrequency in the healing process in chronic wounds. A review in a half-stay hospital

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          Abstract

          RESUMEN Las heridas crónicas son un problema de salud significativo. Parece que la estimulación eléctrica produce una reducción significativamente mayor en el área de superficie y cicatrización más completa de las úlceras de difícil cicatrización y de evolución tórpida en comparación con la terapia habitual, sin vendaje compresivo. Objetivos: Evaluar el efecto que la radiofrecuencia a baja intensidad y con efectos no térmicos tiene sobre los diferentes componentes del mecanismo del proceso de cicatrización. Metodología: Para el tratamiento, se utilizó un dispositivo de tecarterapia (CAPENERGY C200). Se aplicaron un total de 10 sesiones de radiofrecuencia con una periodicidad de 1 vez a la semana con una potencia del 60% y una frecuencia de 1,2 MHz durante 30 minutos. Resultados: La presencia de edema, observada en todos los pacientes en la región de la extremidad inferior, desapareció en 30 de los 36 pacientes (Wilcoxon p = 0,004). Este resultado fue confirmado por ultrasonido. El edema celular subcutáneo medio disminuyó en 1,73 cm (Friedman p = 0,000). La temperatura del área tomada antes y después del tratamiento se incrementó en un promedio de 1,4 °C. Estas diferencias son estadísticamente significativas (Wilcoxon p = 0,000). Conclusiones: La radiofrecuencia parece que puede reducir el largo proceso de cicatrización de las lesiones de evolución tórpida, y nos encontramos con unas diferencias significativas a lo largo del tratamiento y con una reducción progresiva en las mediciones de las lesiones y mayor rapidez en la cicatrización de las heridas complejas.

          Translated abstract

          ABSTRACT Chronic wounds are a significant health problem. Electrical stimulation seems to produce a significantly greater reduction in surface area and more complete healing of difficult-to-heal and poorly healing ulcers compared to standard therapy without compressive bandaging. Objectives: To evaluate the effect that radiofrequency at low intensity and with non-thermal effects has on the different components of the mechanism of the healing process. Methodology: A tecartherapy device (CAPENERGY C200) was used for the treatment. A total of 10 radiofrequency sessions were applied once a week with a power of 60% and a frequency of 1.2 MHz for 30 minutes. Results: The presence of oedema, observed in all patients in the lower extremity region, disappeared in 30 of the 36 patients (Wilcoxon p = 0.004). This result was confirmed by ultrasound. The mean subcutaneous cellular oedema decreased by 1.73 cm (Friedman p = 0.000). The temperature of the area taken before and after treatment increased by an average of °C. These differences are statistically significant (Wilcoxon p = 0.000). Conclusions: Radiofrequency appears to be able to reduce the long healing process of torpidly evolving lesions, and we found significant differences throughout the treatment and a progressive reduction in lesion measurements and faster healing of complex wounds.

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          Most cited references41

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          Regulation of Wound Healing by Growth Factors and Cytokines

          Cutaneous wound healing is a complex process involving blood clotting, inflammation, new tissue formation, and finally tissue remodeling. It is well described at the histological level, but the genes that regulate skin repair have only partially been identified. Many experimental and clinical studies have demonstrated varied, but in most cases beneficial, effects of exogenous growth factors on the healing process. However, the roles played by endogenous growth factors have remained largely unclear. Initial approaches at addressing this question focused on the expression analysis of various growth factors, cytokines, and their receptors in different wound models, with first functional data being obtained by applying neutralizing antibodies to wounds. During the past few years, the availability of genetically modified mice has allowed elucidation of the function of various genes in the healing process, and these studies have shed light onto the role of growth factors, cytokines, and their downstream effectors in wound repair. This review summarizes the results of expression studies that have been performed in rodents, pigs, and humans to localize growth factors and their receptors in skin wounds. Most importantly, we also report on genetic studies addressing the functions of endogenous growth factors in the wound repair process.
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            International clinical recommendations on scar management.

            Many techniques for management of hypertrophic scars and keloids have been proven through extensive use, but few have been supported by prospective studies with adequate control groups. Several new therapies showed good results in small-scale trials, but these have not been repeated in larger trials with long-term follow-up. This article reports a qualitative overview of the available clinical literature by an international panel of experts using standard methods of appraisal. The article provides evidence-based recommendations on prevention and treatment of abnormal scarring and, where studies are insufficient, consensus on best practice. The recommendations focus on the management of hypertrophic scars and keloids, and are internationally applicable in a range of clinical situations. These recommendations support a move to a more evidence-based approach in scar management. This approach highlights a primary role for silicone gel sheeting and intralesional corticosteroids in the management of a wide variety of abnormal scars. The authors concluded that these are the only treatments for which sufficient evidence exists to make evidence-based recommendations. A number of other therapies that are in common use have achieved acceptance by the authors as standard practice. However, it is highly desirable that many standard practices and new emerging therapies undergo large-scale studies with long-term follow-up before being recommended conclusively as alternative therapies for scar management.
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              Interval-level measurement with visual analogue scales in Internet-based research: VAS Generator.

              The present article describes VAS Generator (www.vasgenerator.net), a free Web service for creating a wide range of visual analogue scales that can be used as measurement devices in Web surveys and Web experimentation, as well as for local computerized assessment. A step-by-step example for creating and implementing a visual analogue scale with visual feedback is given. VAS Generator and the scales it generates work independently of platforms and use the underlying languages HTML and JavaScript. Results from a validation study with 355 participants are reported and show that the scales generated with VAS Generator approximate an interval-scale level. In light of previous research on visual analogue versus categorical (e.g., radio button) scales in Internet-based research, we conclude that categorical scales only reach ordinal-scale level, and thus visual analogue scales are to be preferred whenever possible.
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                Author and article information

                Journal
                geroko
                Gerokomos
                Gerokomos
                Sociedad Española de Enfermería Geriátrica y gerontológica (Barcelona, Barcelona, Spain )
                1134-928X
                2021
                : 32
                : 1
                : 63-67
                Affiliations
                [1] Madrid orgnameHospital Guadarrama España
                [6] Madrid Madrid orgnameUniversidad Francisco de Vitoria Spain
                [3] Valencia orgnameUniversidad de Carabobo Venezuela
                [2] Madrid orgnameHospital Guadarrama España
                [5] Madrid Madrid orgnameUniversidad Autónoma de Madrid Spain
                [4] Madrid orgnameHospital Guadarrama España
                Article
                S1134-928X2021000100063 S1134-928X(21)03200100063
                e89b7e63-6fa8-4350-9028-cf7de2df419d

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 19 February 2020
                : 29 October 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 41, Pages: 5
                Product

                SciELO Spain

                Categories
                Helcos

                Heridas crónicas,pie diabético,radiofrecuencia,Diabetic foot,Radiofrequency,Chronic wounds

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