Treatment of decubitus ulcers with low-intensity current - Tips from Other Journals

Date: Feb 1, 1994

Chronic decubitus ulcers remain a major problem, especially in elderly patients, and the success of methods currently used to treat them is variable. Previous studies have shown that a current of 600 [mu]A causes an increase in adenosine triphosphate synthesis and protein synthesis, which are beneficial for skin growth and differentiation. Wood and colleagues conducted a randomized, double-blind, placebo-controlled study to determine the effect of pulsed low-intensity electric current in patients with chronic decubitus ulcers.

The study included 72 patients. The treatment group consisted of 41 patients with a total of 43 stage II or stage III ulcers. The control group consisted of 31 patients with a total of 31 stage II or stage III ulcers. No significant difference was apparent between the two groups in the surface area of the ulcers, previous treatment and age or activity level of the patients. Each patient in the treatment group received a pulsed, low-intensity direct current of 600 [mu]A, which was transmitted via electrodes placed on opposite sides of the ulcer. The control group received treatments with an identical-appearing instrument that did not deliver current. Each ulcer was treated three times per day on alternate days for a total of three treatment sessions per week for eight weeks. Treatment response was determined by measuring the surface area of each ulcer each week.

In the treatment group, 58 percent of the ulcers had healed completely after eight weeks, compared with only 3 percent of ulcers in the control group. A total of 72.9 percent of the treated ulcers decreased more than 80 percent in size, but 12.9 percent of the untreated ulcers decreased a comparable amount. Ten of the 31 ulcers in patients in the control group increased in size during the study, but none of the treated ulcers increased in size.

The authors speculate that in addition to increasing adenosine triphosphate and protein synthesis, pulsed low-intensity direct current facilitates transport of calcium, which is known to be an important factor in the growth and differentiation of cells that promote wound healing. (Archives of Dermatology, August 1993, vol. 129, p. 999.)

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