Finals: Electrotherapy for tissue healing

Question 1

A therapeutic approach involving the application of controlled electrical currents to enhance the body’s natural healing processes, particularly in wound healing and tissue repair.

Answer 1

Electrotherapy for Tissue Healing

Question 2

The concept that human skin exhibits electrical properties similar to those of a battery, with a separation of charge between its interior and exterior layers, creating an electric potential.

Answer 2

Human Skin Battery

Question 2

The region surrounding a wound site where the electrical charge is typically negative, contributing to various physiological activities associated with wound healing, such as cell migration and tissue repair.

Answer 2

Periwound Area

Question 3

The site of tissue damage or injury, characterized by a positive electrical charge due to the disruption of tissue integrity and the release of ions from damaged cells.

Answer 3

Wound Area

Question 3

The series of physiological events and cellular activities involved in the repair and regeneration of damaged tissues, which can be accentuated and supported through the application of electrotherapy modalities.

Answer 3

Healing Process

Question 3

A form of electrotherapy that involves the application of electrical currents to tissues, aiming to modulate cellular activities, promote blood circulation, reduce inflammation, and facilitate tissue regeneration.

Answer 3

Electrical Stimulation

Question 4

Charge of each:
peri wound (?)
wound area (?)

Answer 4

peri wound (negative)
wound area (positive)

Question 5

Movement of Ca++ ions from the anode to the cathode, involving Ca++ and Na+ channel response, which stimulates ATP production.

Answer 5

Cathode-Directed Galvanotaxis

Question 5

Directional movement of cells in response to an electrical field, crucial for processes such as embryogenesis, regeneration, and wound healing.

Answer 5

Galvanotaxis

Question 6

Maintained by Na+:K+ pumps, creating a potential difference between the interior and exterior of the skin.

Answer 6

Normal Electrical Charge Across Skin and Cell Membrane

Question 7

Charged ions leak out of cells, causing the center of the wound to be electrically charged relative to the surrounding uninjured tissue.

Answer 7

Electrical Charge During Tissue Injury

Question 8

Lymphocytes, platelets, mast cells, keratinocytes, neural progenitor cells, fibroblasts, and activated neutrophils.

Answer 8

Cells Attracted to Cathode

Question 8

Macrophages, epidermal cells, and inactive neutrophils.

Answer 8

Cells Attracted to Anode

Question 8

The positive electrode should be used to promote healing.

Answer 8

Electrode Use for Necrotic Wounds without Inflammation

Question 8

The negative electrode should be used to promote healing.

Answer 8

Electrode Use for Infected or Inflamed Wounds

Question 8

Essential for the proliferation phase, they produce collagen, aiding in tissue repair and strength.

Answer 8

Role of Fibroblasts in Tissue Healing

Question 9

Activates fibroblasts, enhancing their replication, DNA and collagen synthesis, upregulating growth factor pathways, and inducing them to become myofibroblasts.

Answer 9

Electrical Stimulation of Fibroblasts

Question 10

Triggers calcium channels to open, increasing intracellular calcium levels and stimulating fibroblast activity.

Answer 10

Effect of Electrical Stimulation on Calcium Channels

Question 10

Electrical stimulation increases VEGF production, stimulating microcirculation development near the wound and enhancing oxygen/nutrient delivery.

Answer 10

VEGF in Wound Healing

Question 11

Maximum calcium influx and protein/DNA synthesis occur with high-volt pulsed current (HVPC) with a peak voltage of 60 to 90 V.

Answer 11

Voltage-Dependent Cellular Responses

Question 12

Monophasic pulsed current is commonly used, but alternating and biphasic currents may also have benefits by activating cells despite lacking a net charge effect.

Answer 12

Types of Electrical Currents for Wound Healing

Question 12

Antimicrobial Effects of Monophasic Currents

Answer 12

Monophasic currents, including microampere level DC and HVPC, can kill bacteria in vitro, likely due to the electrolytic generation of hypochloric acid.

Question 13

Requires much higher voltages or longer durations than typically used in clinical settings.

Answer 13

Application of Electrical Current to Inhibit Bacterial Growth

Question 14

Monophasic or direct current electrical stimulation can enhance the activity of some antibiotics against bacteria in biofilms.

Answer 14

Enhanced Antibiotic Activity with Electrical Stimulation

Question 15

Increases circulation during and after application, accelerates angiogenesis via VEGF, and should be applied in a warm room.

Answer 15

Enhanced Circulation with Electrical Stimulation

Question 16

Uses a twin-peaked monophasic pulsed current waveform with peak voltage between 150-500 V, pulse duration of 50-100 usec, and frequency of 1-120 Hz.

Answer 16

High Voltage Pulsed Current (HVPC)

Question 17

Modes of HVPC Application

Answer 17

Modes of HVPC Application

Question 17

Modes of HVPC Application

Answer 17

Low Intensity Electrical Stimulation

Question 18

Can expedite return to activities from acute injuries, reducing inflammation-associated edema and avoiding the risks associated with medications like ibuprofen.

Answer 18

Edema Control with Electrical Stimulation

Question 18

Used to treat chronic stage III or IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers that have not responded to standard treatment in 30 days.

Answer 18

Chronic Wounds and Electrical Stimulation

Question 19

Treated with negative polarity electrical stimulation at 120 pulses/s and 90% of visible motor contraction, for four 30-minute sessions 4 hours apart or one continuous 180-minute session.

Answer 19

Edema Due to Inflammation

Question 19

Contraindication of Electrical Stimulation for Edema

Answer 19

Should not be used for edema caused by systemic disorders (e.g., heart failure) as it may exacerbate central fluid overload and increase the risk of pulmonary edema.

Question 20

Treated with motor-level electrical stimulation to produce muscle contractions, promoting venous and lymphatic return flow and reducing distal extremity edema.

Answer 20

Edema Due to Lack of Muscle Contraction

Question 21

Uses low-amplitude DC to deliver drugs through the skin by repelling similarly charged ions and increasing skin permeability, commonly used for anti-inflammatory corticosteroid dexamethasone.

Answer 21

Iontophoresis for Transdermal Drug Delivery

Question 21

Avoids gastrointestinal distress, bad taste, low bioavailability, pain, and risks associated with oral, nasal, or parenteral drug administration.

Answer 21

Benefits of Iontophoresis Over Other Drug Delivery Methods