ELECTRICAL STIMULATION FOR TISSUE HEALING

Question 1

4 stages of wound healing

Answer 1

Hemostasis
Inflammation
Proliferation
Maturation

Question 2

Cascade of initial hemodynamic reactions where in
the platelet will aggregate to stop/control the
bleeding

• Followed by influx of various inflammatory cells

Answer 2

Hemostasis

Question 3

first line of defense for any tissue
injuries

Answer 3

Neutrophils

Question 4

Hemostasis process

Answer 4

Aggregation of platelet
Influx of neutrophils
Neutrophils release mediators & cytokinesis

Question 5

cells responsible for cleaning the wound and
protecting it from injuries

Answer 5

Neutrophils, macrophages, and lymphocytes

Question 6

Inflammatory process

Answer 6

Neutrophils, macrophages, and lymphocytes cleaning of wound and protecting from injuries

Vasodilation of blood vessels (better circulation, inc vasopermeability) = inc heat, erythema, inc flow

Phagocytosis ( neutrophils and macrophages will migrate towards the area)

Lymphocytes = cellular immunity and antibody production + mediator

Inflammation would trigger the release of growth factor

Question 7

Proliferation phase

Answer 7

Reconstruction part of wound healing

Cells are working in order to form granulation tissues
and to allow formation of new epithelial cells and
restore the function of skin and blood vessels

Fibroblast
-granulation of tissues
- myofibrolast = wound contraction + inc tissue strength
- collagen synthesis
-protoglycan, ground substance=collagen- based scar tissue
-matrix deposition

Angiogenesis
- blood vessels
- endothelial cells= migration & replication= new blood vessels formation

Epithelial cells
-coverings, skin
- re-epithelialization

Question 8

Remodelling phase

Answer 8

Cells are becoming more mature
• Maturation phase
• Can start early during the 3rd week or after a month,
or even up to a year
• Collagen remodels to ensure better tensile strength
of the healed area
o Collagen is reorganized and reoriented

Question 9

Types of current for wound healing

Answer 9

Low intensity direct current
High voltage pulsed current
Russian current
Biphasic pulsed current

Question 10

Monophasic waveform that is continuous or pulsed
modulated with polarity reversal

Answer 10

LIDC

Question 11

Type of current and peak amplitude of LIDC

Answer 11

amp: 99 ma
Type: constant

Question 12

Twin-peak monophasic pulses
o 2 high peaks that are seen in the waveform

Answer 12

HVPC

Question 13

Peak voltage of hvpc, pulse duration, type

Answer 13

500 V, 10-100 msec, constant

Question 14

MFBurstAC wave, wave output, burst, type

Answer 14

Sine, 2500-5000 Hz, 50 burst per sec, polyphasic time-modulated AC

Question 15

The human epidermis exhibits a natural endogenous
battery
o Generates small electric current when we
are wounded

Answer 15

Normal skin battery

Question 16

Location of normal skin battery

Answer 16

Between stratum corneum and dermis

Question 17

system to maintain tissue
health

Answer 17

Direct current

Question 18

mimics and amplifies the weak
human skin batteries at the wound site

Answer 18

Microcurrent

Question 19

Attraction of cells to an electrical charge

Answer 19

Galvanotaxis

Question 20

key feature in wound healing

Answer 20

Polarity

Question 21

Cells towards the anode

Answer 21

Neutrophils
Vascular endothelial cells
Macrophages

Question 22

Cells towards the cathode

Answer 22

Monocytes, fibroblasts, epidermal cells, keratinocytes

Question 23

Wound healing waveform

Answer 23

LIDC & HVPC

Question 24

Lidc wound healing parameter
W, m, pf, pd, a, time

Answer 24

W: LIDC
Pf: cont 0 hz, pulsed 100-200 hz
Pd: n/a
Amp: comfortable tingling (1-999 mA)
Time: 30- 90 min

Question 25

HVPC
W, m, pf, pd, a, time

Answer 25

W: HVPC
Mode: pulsed
pf: 60-125 pps, 1-200 hz
Pd: 40-100 msec
Amp: Comfortable tingling (150-500 V)
Time: 45 - 60 min, 30-90 mins

Question 26

Edema Control waveform

Answer 26

HVPC (inflammation) /BPC (immobilization)

Question 27

Edema d/t inflammation parameters

W, m, pf, pd, a, time

Answer 27

W: HVPC
M: Pulsed
Pf: 100-120 Hz
Pd: 40-100mSec
Amp: Comfortable tingling
Time: 20-30min

Question 28

Edema d/t immobilization

W, m, pf, pd, a, time

Answer 28

W: BPC
M: Pulsed
Pf: 30-50 pps, 2-5 sec on:off time
Pd: 150- 350 usec
Amp: visible contraction
Time: 20-30min

Question 29

Blood circulation

W, m, pf, pd, a, time

Answer 29

W: bpc
M: pulsed
Pf: 30-50 pps/hz, 1-2 sec on:off time
Amp
Visible contractions
Time: 20-30 min

Question 30

Considerations

Answer 30

Electrode placement
o Over the wound: if wound is already closed
o Around the wound: if there are still infection
or aseptic issues

• Infection control
o Wrap electrodes with sterile gauze pads;
saturate pads with normal saline solution
o Observe proper aseptic techniques (use of
gloves, mask, gown and goggles)

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