eStim for Wound healing and edema Flashcards
Name the 6 wound healing indications (3 ulcers and 3 wounds)
1) Pressure Ulcers
2) Diabetic Ulcers
3) Venous Ulcers
4) Traumatic Wounds
5) Surgical Wounds
6) Burn Wounds
Define galvanotaxis
Cellular movement that is stimulated by electric current
What activates the alteration of cellular membranes?
Electric current leads to synthesis of collagen and DNA (60-90 volts)
Name 2 modifications electrical stimulation can have on the cells
1) Reverse the normal electrical potential of cells
2) Enhance the electrical potential of cells
Name 2 ways the electrodes can be placed with wound healing
1) Electrodes with wet surface placed directly on the wound bed
- Keeping wound wet w/ 0.9% saline maintains the appropriate charge of tissue needed to encourage healing.
2) Electrodes placed around the wound not in direct contact with the wound
How does the HVPC waveform look like?
2 spikes
HVPC (High Volt Pulsed Curent): Non-motor or non sensory quality?
Non-motor quality
HVPC (High Volt Pulsed Curent): Long or short pulses?
Short pulses
HVPC (High Volt Pulsed Curent): Rapid reduction or slow reduction of current amplitude?
Rapid reduction of current amplitude
HVPC for wound healing: Pulse width?
40-100 microseconds
HVPC for wound healing: Polarity?
Polarity (+) or (-)
HVPC for wound healing: Pulse rate?
60-125 (pps)
HVPC for wound healing: Treatment time?
45-60 min
HVPC for wound healing: Treatment frequency?
Up to 5 days/week
HVPC for wound healing: Sevel protocols exist and are depending on what?
Depends on phase of tissue healing: inflammatory, proliferative/epithlialization, remodeling
Name 10 contraindications for HVPC wound healing
1) Cardiac Pacemaker, Bladder stimulator
2) Superficial metal implants
3) Significant impaired sensation
4) Pregnancy
5) Osteomyelitis
6) Transthoracic/cervical region
7) Along phrenic nerve
8) Malignancy
9) Carotid sinus, laryngeal musculature
10) Over topical substances with metal ions
What type of charge does injured tissue have?
Positive
When a wound has necrotic tissue; proliferative stage of healing; inflammation is not present, what type of charge does it attract?
(+) anode
When a wound is infected; inflammed tissue, what type of charge does it attract?
(-) cathode
In wound healing, (+) anode attracts these 3 things?
1) inactive neutrophils
2) Macrophages
3) Epidermal cells
In wound healing, (-) cathode attracts which 6 things?
1) Active neutrophils
2) Lymphocytes
3) Platelets
4) Mast cells
5) keratinocytes
6) fibroblasts
Wound healing activation: Cellular membranes are altered by electric current leading to synthesis of __ and __ (__-__ volts)
Cellular membranes are altered by electric current leading to synthesis of collagen and DNA (60-90 volts)
Acute edema - Lower or higher frequency?
Higher frequency
Acute edema - motor or no motor response?
no motor
Acute edema - HVPC or Biphasic?
HVPC
Chronia edema - Lower or higher frequency?
lower freq
Chronia edema - motor or no motor response?
motor response
Chronia edema - HVPC or Biphasic?
Biphasic waveform
Name 3 mechanistic theories behind acute edema
1) Decreases initial surge of blood following acute injury
2) Repels negatively charged proteins involved in inflammatory process
3) Decrease porous properties of blood vessels thereby affecting protein migration
Acute Edema: Polarity?
(-)
Acute Edema: Pulse frequency?
100-120 pps
Acute Edema: Pulse Duration?
40-100 microsec
Acute Edema: Current Amplitude?
pt comfort
Acute Edema: Treatment time?
20-30 min
Chronic Edema: Polarity?
Biphasic waveform
Chronic Edema: Pulse freq?
35-50 pps
Chronic Edema: On:off (surge)
equal, b/w 2-5 sec
Chronic Edema: Pulse Duration?
150-350 microsec
Chronic Edema: Amplitude?
Motor response
Chronic Edema: Treatment time?
20-30 min
Iontophoresis: Which stage of tissue healing?
inflammatory
Iontophoresis: What two types of pain?
acute and chronic
Iontophoresis: 2 advantages over other types of treatment?
1) pts who are unable to receive injections (fear, supressed immune system)
2) Bypasses liver and GI tract so no absorbed in GI tract, therefore, potency is maintained
5 Therapeutic goals of Iontophoresis: 1) Relieve pain and inflammation associated with these 3 things 2) Dissolving __ __ 3) E__ 4) Scar __ and a__ 5) hyper__
1) Relieve pain and inflammation associated with:
2) Tendonitis, Plantar fasciitis (PF), bursitis
3) Dissolving calcium deposits (calcific tendonitis)
4) Edema
5) Scar tissue and adhesions
6) Hyperhidrosis
Iontophoresis: Dose in mA-min
40-60 (80) mA-min
Iontophoresis: Current Amplitude? no greater than what?
no > 4.0 mA
Iontophoresis: Treatment time?
Dependent on dose and current
Iontophoresis: Equation?
Current Amplitude (mA) x Treatment Duration (min)= Dose (mA-min)
Iontophoresis: Adverse Effects?
Alkaline Reaction (-) Acidic Reaction (+)
Current Density
Current Amplitude
Iontophoresis: Maximum current density for anode (+)?
no > 1.0 mA/cm2
Iontophoresis: Maximum current density for cathode (-)?
no > 0.5 mA/cm2
Iontophoresis: Dexamethasone, - or +?
(-)
Iontophoresis: Acetic Acid, - or +?
(-)
Iontophoresis: Lidocaine, - or +?
(+)
Iontophoresis: Name the 6 contraindications (4 of them you ask the patient)
1) Impaired sensation
2) Cardiac pacemakers/arrhythmia
3) Pregnancy
4) Previous drug allergy/adverse drug reaction
5) Altered skin integrity
6) Carotid Sinus
