E-stim for tissue healing and iontophoresis Flashcards
1
Q
Wound healing stages
A
- hemostasis and coagulation
- inflammation: lysis = removal or cellular debris
- proliferation and migration: neutrophils and lymphocytes come to the area
- remodeling
**typically with chronic wounds they get stuck in the inflammatory/proliferative phase
2
Q
Purpose/effects of E-stim for tissue healing
A
- stimulate cells
- increase blood flow
- combat infeciton
- reduce edema
- increase protein synthesis and cell migration
3
Q
Mechanism for wound healing
A
- ionic effects (galvanotaxis)
- germicidal effect
4
Q
Ionic effects of wound healing (galvanotaxis)
A
- the attraction of cells to an electrical charge
- used to induce cell migration
- E-stim for tissue healing is depend on net charge
- negative electrode attracts positively charged ions and repels negatively charged ions and vice versa for positive electrode
5
Q
Germicidal effects of wound healing
A
- monophasic currents have been shown to inhibit bacteria growth and kill bacteria
6
Q
Waveforms that create ionic effects
A
- DC current
- Pulsed monophasic current
- unbalanced biphasic current
- Monophasic pulsed current: HVGS = high volt galvanic stimulation; HVPC = high volt pulsed current (most common)
7
Q
Ionic effects based on the theory of attraction
A
- neutrophils, macrophages, lymphocytes, platelets, mast cells, keratinocytes and fibroblasts can be attracted to a wound based on the charge they carry
- Negative charge is used for treatment of infection/inflamed wounds
- positive charge is used for treatment for epithelialization or if the wound healing plateaues
8
Q
Pre- set up considerations
A
- check sensation (may be impaired so can check intensity on a near by area)
- use infection control methods for infected wounds
9
Q
Infection control methods for infected wounds
A
- single use electrode
- use standard precautions used when blood or body fluids may be present
- dispose of gauze properly
- personal protective equipment
10
Q
Electrode placement for tissue healing
A
- one electrode is treatment electrode; has polarity and placed in or around wound
- Dispersive electrode: at least 2x the surface area of active electrode
11
Q
Monopolar set up for tissue healing
A
- smaller electrode is treatment electrode
- larger dispersive electrode of opposite polarity is placed on intact skin, close to the wound site
- dispersive: larger size allows current to be dispersed over a larger area for more comfort and not limiting intensity of other electrode
12
Q
Direct vs indirect method for tissue healing
A
- direct = treatment electrode is directly over wound
- indirect = bifurcating electrodes around the wound
13
Q
Parameters for tissue healing e-stim
A
- waveform: monophasic pulsed current or HVPS (HVGS)
- polarity: (-) inflammatory phase/infection or (+) for epithelialization/proliferation phase or clean
- pulsed duration: can be preset but usually 40-100 microseconds
- pulse freq. 60-125
- amplitude: to comfortable tingling sensation without a motor response
- treatment: 40-60 minutes
14
Q
Iontophoresis
A
- based on theory of repulsion
- the use of low amplitude DC current to facilitate trans-dermal drug delivery
- based on the theory that like charges repel and fixed charge can push the drug away from electrode
- uses a monopolar set up – one treatment and one larger dispersive electrode
15
Q
Effects of DC current (iontophoresis)
A
- to promote contious delivery of a drug continuous DC current is necessary
