The Healing Effects of Electrical Stimulation

Electrical currents within the human skin were discovered as far back as 1860, and it has since been shown that the skin surface is negatively charged compared with the deeper skin layers, and that wounds have a positive potential compared to the surrounding intact skin.

Electrical Stimulation Current Types

Knowledge of the underlying electrical activity of wounds lead researchers to examine the use of electrical stimulation in chronic wound healing. Four primary types of stimulation have been developed and are currently used in clinical practice:

  • Direct current was the earliest modality studied and involves applying a small current across two electrodes, one of which is placed within the wound and the other on the skin surface distant to the wound
  • Low frequency pulsed current, more commonly known as transcutaneous electrical nerve stimulation (TENS), is a technique popular in physical therapy and pain control, including during child birth
  • High-voltage pulsed current utilizes output voltages from 100-500 V (typically <200 V) with a short pulse duration and a low current. Study results have been mixed but there appears to be an improved rate of healing when compared to controls with this form of therapy
  • Pulsed electromagnetic field (PEMF) therapy, which delivers energy at a particular pulse rate has shown improved rates and overall healing when compared to placebo

Electrical stimulation is indicated as an adjunct for chronic or recalcitrant wounds, pressure ulcers, neuropathic ulcers, venous ulcers, arterial ulcers, traumatic and surgical wounds, and burns. This modality is also recommended by the Clinical Practice Guidelines for Treatment of Pressure Ulcers (stages III and IV). Electrical stimulation should not be used in simple wounds, wounds with osteomyelitis, or actively bleeding wounds. In addition, this therapy should not be used in combination with topical agents containing heavy metal ions.

Electrical Stimulation & Wound Healing

Many studies have been undertaken to understand the mechanisms of wound healing by electrical stimulation. The precise mechanism appears relatively complex and is thought to involve seven distinct actions:

  1. Restoring the current of injury
  2. Inducing galvanotaxis
  3. Stimulating cells
  4. Increasing blood flow
  5. Increasing bactericidal abilities
  6. Reducing edema
  7. Facilitating debridement

Although research into electrical stimulation has produced mixed results, there does seem anecdotal evidence to support its use in many types of wounds, with some practitioners claiming to find the technique highly beneficial.

Electrical stimulation is just one type of adjunctive therapy that is covered as part of the training for wound certification. Studying for wound certification is an ideal way to improve your knowledge of all aspects on wound management and to pursue those topics of interest.

Learn More With Our Wound Care Education Options

Interested in learning more about wound care and certification? Browse through our wound care certification courses for information on our comprehensive range of education options to suit healthcare professionals across the full spectrum of qualifications and experience.

References

  1. Tibbles PM, Edelsber JS. Hyperbaric-oxygen therapy. The New England J Med 1996;334:1642-1648
  2. Barker AT, Jaffe LF, Vanable JW. The glabrous epidermis of cavies contains a powerful battery. Am J Physiol 1982;242:R358-366
  3. Vodovnik L, Karba R. Treatment of chronic wounds by means of electric and electromagnetic fields, part 1. Med&BioEng&Comp 1992;30(3):257-266
  4. Hess CL, Howard MA, Attinger CE. A review of mechanical adjuncts in wound healing: hydrotherapy, ultrasound, negative pressure therapy, hyperbaric oxygen, and electrostimulation. Ann Plast Surg. 2003;51(2):210-8.
  5. Weber SA, Vonhoff PA, Owens FJ, Byrne J, McAdams ET. Development of a multi–electrode electrical stimulation device to improve chronic wound healing. Conf Proc IEEE Eng Med Biol Soc 2009;2009:2145-8.
  6. Burdge JJ, Hartman JF, Wright ML. A study of HVPC as an adjunctive therapy in limb salvage for chronic diabetic wounds of the lower extremity. Ostomy Wound Manage. 2009;55(8):30-8
  7. Goldman R, Rosen M, Brewley B, Golden M. Electrotherapy promotes healing and microcirculation of infrapopliteal ischemic wounds: a prospective pilot study. Adv Skin Wound Care. 2004;17(6):284-94.
  8. Gentzkow GD. Electrical stimulation to heal dermal wounds. J Derm Surg Onc 1993;19:753-758

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