PHYSMOD_ ES FOR WOUND HEALING

Electrical stimulation for tissue healing and repair / wound healing

• ______ regeneration

• ______ control

• Improved _____

• Tissue regeneration

• Edema control

• Improved circulation

Wound Healing Process

HIPM

Homeostasis → Inflammation → Proliferation → Maturation

Wound Healing Process

Types of Currents used for wound healing:

MHRB

• Microcurrents/ Low Intensity DC

• High Voltage Pulsed Current

• Russian Currents

• Biphasic Pulsed Currents

Current

__________

• Monophasic waveform that is continuous or pulsed modulated with polarity reversal

• Peak amplitude of 999 uA/ < 1ma

• Uses of Constant Current

Microcurrents/ Low Intensity DC

Current

__________

• Twin-peak monophasic pulses

• Peak voltage of 500V

• 10-100 USEC pulse duration

• Uses Constant Voltage

HVPC

Current

__________

• Continuous sine wave output of about 2500-5000Hz

• Modulated to yield 50 bursts per second

• Each burst is polyphasic time-modulated AC

MFBurstAC ( Russian Current)

Mother Fucker Burst AC = russian current

Current

__________

• When muscle contraction is required to reduce edema

BPC

Biophysical Characteristics

• Normal Skin battery

  • Found between stratum _____ and ______

  • _____ current bioelectrical system to maintain tissue health

  • Current flow shift to the _____ area → “Current of Injury”

  • _____ or _____ mimics and amplifies the weak human skin batteries at the wound site

• Found between stratum corneum and dermis

• Direct current bioelectrical system to maintain tissue health

• Current flow shift to the injured area → “Current of Injury”

• Microcurrent or HVPC mimics and amplifies the weak human skin batteries at the wound site

Physiological Basis

• General Effects

  • ________

    • Attraction of cells to an electrical
      charge

    • Electrical stimulation promotes
      tissue healing by ____ effects →
      attract or repels charged particles

    • Due to ______

Galvatoxais

• ionic

• POLARITY

Physiological Basis

Physiological Basis: General Effects of Galvanotaxis

Physiological Basis: General Effects of Galvanotaxis

Phases of Wound Healing → Effects

• Inflammation →______

• Proliferative →_______

• Maturation → ______

Anode (+) for Inflammation Phase; Cathode (-) for Proliferative & Maturation Phase

• Inflammation → Phagocytosis & Autolysis

• Proliferative → Fibroplasia

• Maturation → Wound Contraction

Cont.

Phases of Wound Healing → Cell Polarity

• Inflammation →______

• Proliferative →_______

• Maturation → ______

• Macrophages (-); Neutrophils (-)

• Fibroblasts (+)

• Keratinocytes (+), Epidermal Cells (+)

Physiological Basis: General Effects in Inflammation Phase

• Initiates the ____ repair process by its effect on the current of injury

• INC ____ flow

• Promotes _____

• Enhances tissue _____

• Controls ____

• Solubilizes ____ products including ____ tissue

• Initiates the wound repair process by its effect on the current of injury

• Increases blood flow

• Promotes phagocytosis

• Enhances tissue oxygenation

• Controls infection

• Solubilizes blood products including necrotic tissue

Physiological Basis: General Effects in Proliferative Phase

• Stimulates ____ and _____ cells

• Stimulates DNA and protein _____

• _____ ATP generation

• Improves ____ transport

• Produces better _____ matrix organization

• Stimulates wound _____

• Stimulates fibroblasts and epithelial cells

• Stimulates DNA and protein synthesis

• Increases ATP generation

• Improves membrane transport

• Produces better collagen matrix organization

• Stimulates wound contraction

Physiological Basis: General Effects in Maturation Phase

• Stimulates _____ cell reproduction and migration

• Produces a ____, ___ scar

• Stimulates epidermal cell reproduction and migration

• Produces a smoother, thinner scar

Physiological Basis: General Effects in Germicidal Effect

• Inhibiting the growth of action of microorganisms

  • Escherichia coli

  • Pseudomonas aeruginosa

  • Staphylococcus aureus

• Conflicting evidences whether anode or cathode

• just read it ;)

Physiological Basis: General Effects for Edema Control

• Due to ____

  • Electrical stimulation is indicated

• Due to _____

  • Electrical stimulation is indicated

• Due to ____ disorders

  • Electrical stimulation is contraindicated

Clue: IIS

• Due to inflammation

  • Electrical stimulation is indicated

• Due to immobility

  • Electrical stimulation is indicated

• Due to systemic disorders

  • Electrical stimulation is
    contraindicated

Physiological Basis: General Effects for Edema Control

• Due to Inflammation

  • ES to retard ____ formation

  • ES CANNOT DEC _____

  • Use of ____ → repels negatively charged proteins back to blood vessels & reduces pore size in microvessel walls

• _____ at sensory level stimulation

• Due to Inflammation

  • ES to retard edema formation

  • ES cannot decrease edema

  • Use of cathode → repels negatively charged proteins back to blood vessels & reduces pore size in microvessel walls

• HVPC at sensory level stimulation

Physiological Basis: General Effects for Edema Control

• Due to immobility

  • Muscle contraction → _____ effect

  • ES should be used together with ____ elevation and followed by

    _____

• Due to immobility

  • Muscle contraction → Pumping effect

  • ES should be used together with limb elevation and followed by

    compression

Physiological Basis: General Effects for Improving Circulation

• Conflicting evidences in improving circulation via muscle contraction

womp

Indications

• ____und healing

  • Burns

  • Ulcers (pressure, vascular or

    neuropathic)

  • Surgical wounds

• _____

• Retardation of ____

• Reduction of _____

• _____ blood flow

• Wound healing

  • Burns

  • Ulcers (pressure, vascular or

    neuropathic)

  • Surgical wounds

• Infections

• Retardation of edema

• Reduction of edema

• Increase blood flow

Considerations

• Electrode Placement

  • Over the wound

  • Around the wound

• Infection control

  • Wrap electrodes with sterile gauze pads; saturate pads with normal saline
    solution

  • Observe proper aseptic techniques (use of gloves, mask, gown and goggles)

• Electrodes

  • Should be warmer than the wound but not warmer than 380C

Dosimetry Wound Healing

Parameters → LIDC → HVPC

• Waveform →

• Mode

• Polarity →

• Pulse Frequency →

• Pulse Duration →

• Amplitude →

• Treatment Time →

LIDC

• Waveform → LIDC

• Mode → Continuous Pulsed

• Polarity → Negative (cells); use anode ;Positive (cells); use cathode

• Pulse Frequency → Continuous: 0 Hz ;Pulsed: 1-200 Hz

• Pulse Duration → NA

• Amplitude → Comfortable tingling (1-999 μA)

• Treatment Time → 30-90 min

Dosimetry Wound Healing

Parameters → LIDC → HVPC

• Waveform →

• Mode

• Polarity →

• Pulse Frequency →

• Pulse Duration →

• Amplitude →

• Treatment Time →

HVPC

• Waveform → HVPC

• Mode → Pulsed

• Polarity → Negative (cells); use anode ;Positive (cells); use cathode

• Pulse Frequency → 60-125 pps/Hz , 1-200 Hz

• Pulse Duration → 40-100 usec

• Amplitude → Comfortable tingling (150-500 μA)

• Treatment Time → 45-60 min, 30-90min

Dosimetry Edema Control

Parameters → Inflammation

• Waveform →

• Mode

• Polarity →

• Pulse Frequency →

• Pulse Duration →

• Amplitude →

• Treatment Time →

Inflammation

• Waveform → HVPC

• Mode → Pulsed

• Polarity → Negative (cells); use anode

• Pulse Frequency → 100-120 pps/Hz

• Pulse Duration → 40-100 usec

• Amplitude → Comfortable tingling

• Treatment Time → 20-30min

Dosimetry Edema Control

Parameters → Immobilization

• Waveform →

• Mode

• Polarity →

• Pulse Frequency →

• Pulse Duration →

• Amplitude →

• Treatment Time →

Imobilization

• Waveform → BPC

• Mode → Pulsed

• Polarity → NA

• Pulse Frequency → 30-50 pps / Hz; 2-5 sec equal on:off time

• Pulse Duration → 150-350 usec

• Amplitude → Visible Contraction

• Treatment Time → 20-30min

Dosimetry INC BLOOD FLOW

Parameters → Circulation

• Waveform →

• Mode →

• Polarity →

• Pulse Frequency →

• Pulse Duration →

• Amplitude →

• Treatment Time →

• Waveform → BPC

• Mode → Pulsed

• Polarity → NA

• Pulse Frequency → 30-50 pps/Hz; 1-2 sec equal on:off time

• Pulse Duration →150-350 usec

• Amplitude → Visible Contraction

• Treatment Time → 20-30 min