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Chronic Dermal Ulcer Healing Enhanced with Monophasic Pulsed Electrical Stimulation

JA Feedar, BS, PT, is Director and Vice President, Wound Care Resources Inc, and Director and President, Preferred Physical Therapy Services of Wisconsin SC, 8320 W Bluemound Rd, Ste 213, Milwaukee, WI 53213. He was Director of Therapy Services, Omni Therapy Inc, 1810 Kensington Dr, Waukesha, WI 53188, when this study was conducted.
LC Kloth, MS, PT, is Associate Professor, Program in Physical Therapy, Marquette University, Milwaukee, WI 53233-2269 (USA); President, Wound Care Resources Inc; and Vice President, Preferred Physical Therapy Services of Wisconsin SC.
GD Gentzkow, MD, is Vice President and Medical Director, Staodynamics Inc, 1225 Florida Ave, PO Box 1379, Longmont, CO 80502-1379.

The purposes of this randomized, double-blind, multicenter study were to compare healing of chronic dermal ulcers treated with pulsed electrical stimulation with healing of similar wounds treated with sham electrical stimulation and to evaluate patient tolerance to the therapeutic protocol. Forty-seven patients, aged 29 to 91 years, with 50 stage II, III, and IV ulcers were randomly assigned to either a treatment group (n=26) or a control (sham treatment) group (n=24). Treated wounds received 30 minutes of pulsed cathodal electrical stimulation twice daily at a pulse frequency of 128 pulses per second (pps) and a peak amplitude of 29.2 mA if the wound contained necrotic tissue or any drainage that was not serosanguinous. A saline-moistened nontreatment electrode was applied 30.5 cm (12 in) cephalad from the wound. This protocol was continued for 3 days after the wound was debrided or exhibited serosanguinous drainage. Thereafter, the polarity of the treatment electrode on the wound was changed every 3 days until the wound progressed to a stage II classification. The pulse frequency was then reduced to 64 pps, and the treatment electrode polarity was changed daily until the wound was healed. Patients in the control group were treated with the same protocol, except they received sham electrical stimulation. After 4 weeks, wounds in the treatment and control groups were 44% and 67% of their initial size, respectively. The healing rates per week for the treatment and control groups were 14% and 8.25%, respectively. The results of this study indicate that pulsed electrical stimulation has a beneficial effect on healing stage II, III, and IV chronic dermal ulcers.

Key Words: Dermal ulcers • Electrical stimulation • Ischemic ulcers • Wound healing

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