Finals: Electrotherapy for tissue healing Flashcards
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.
Electrotherapy for Tissue Healing
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.
Human Skin Battery
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.
Periwound Area
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.
Wound Area
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.
Healing Process
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.
Electrical Stimulation
Charge of each:
peri wound (?)
wound area (?)
peri wound (negative)
wound area (positive)
Movement of Ca++ ions from the anode to the cathode, involving Ca++ and Na+ channel response, which stimulates ATP production.
Cathode-Directed Galvanotaxis
Directional movement of cells in response to an electrical field, crucial for processes such as embryogenesis, regeneration, and wound healing.
Galvanotaxis
Maintained by Na+:K+ pumps, creating a potential difference between the interior and exterior of the skin.
Normal Electrical Charge Across Skin and Cell Membrane
Charged ions leak out of cells, causing the center of the wound to be electrically charged relative to the surrounding uninjured tissue.
Electrical Charge During Tissue Injury
Lymphocytes, platelets, mast cells, keratinocytes, neural progenitor cells, fibroblasts, and activated neutrophils.
Cells Attracted to Cathode
Macrophages, epidermal cells, and inactive neutrophils.
Cells Attracted to Anode
The positive electrode should be used to promote healing.
Electrode Use for Necrotic Wounds without Inflammation
The negative electrode should be used to promote healing.
Electrode Use for Infected or Inflamed Wounds
Essential for the proliferation phase, they produce collagen, aiding in tissue repair and strength.
Role of Fibroblasts in Tissue Healing
Activates fibroblasts, enhancing their replication, DNA and collagen synthesis, upregulating growth factor pathways, and inducing them to become myofibroblasts.
Electrical Stimulation of Fibroblasts
Triggers calcium channels to open, increasing intracellular calcium levels and stimulating fibroblast activity.
Effect of Electrical Stimulation on Calcium Channels
Electrical stimulation increases VEGF production, stimulating microcirculation development near the wound and enhancing oxygen/nutrient delivery.
VEGF in Wound Healing
Maximum calcium influx and protein/DNA synthesis occur with high-volt pulsed current (HVPC) with a peak voltage of 60 to 90 V.
Voltage-Dependent Cellular Responses
Monophasic pulsed current is commonly used, but alternating and biphasic currents may also have benefits by activating cells despite lacking a net charge effect.
Types of Electrical Currents for Wound Healing
Antimicrobial Effects of Monophasic Currents
Monophasic currents, including microampere level DC and HVPC, can kill bacteria in vitro, likely due to the electrolytic generation of hypochloric acid.
Requires much higher voltages or longer durations than typically used in clinical settings.
Application of Electrical Current to Inhibit Bacterial Growth
Monophasic or direct current electrical stimulation can enhance the activity of some antibiotics against bacteria in biofilms.
Enhanced Antibiotic Activity with Electrical Stimulation
Increases circulation during and after application, accelerates angiogenesis via VEGF, and should be applied in a warm room.
Enhanced Circulation with Electrical Stimulation
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.
High Voltage Pulsed Current (HVPC)
Modes of HVPC Application
Modes of HVPC Application
Modes of HVPC Application
Low Intensity Electrical Stimulation
Can expedite return to activities from acute injuries, reducing inflammation-associated edema and avoiding the risks associated with medications like ibuprofen.
Edema Control with Electrical Stimulation
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.
Chronic Wounds and Electrical Stimulation
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.
Edema Due to Inflammation
Contraindication of Electrical Stimulation for Edema
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.
Treated with motor-level electrical stimulation to produce muscle contractions, promoting venous and lymphatic return flow and reducing distal extremity edema.
Edema Due to Lack of Muscle Contraction
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.
Iontophoresis for Transdermal Drug Delivery
Avoids gastrointestinal distress, bad taste, low bioavailability, pain, and risks associated with oral, nasal, or parenteral drug administration.
Benefits of Iontophoresis Over Other Drug Delivery Methods
