Lecture 23 - Wound Healing and Biophysical Agents Flashcards
what modalities are used for wound healing?
1) Electrical Stimulation Therapy
–High Voltage Pulsed Current
–Low-Intensity Direct Current
2) Therapeutic Ultrasound
–Conventional
–Low-Frequency
3) Light Therapy
–Ultraviolet
–Infrared
–Low Level LASER
4) Negative Pressure
5) Hydrotherapy
6) Intermittent Pneumatic Compression (next lecture)
what are 4 types of chronic pressure wounds?
- Pressure Ulcers
- Venous Ulcers
- Arterial Ulcers
- Neuropathic Ulcers
what are potential physiological effects of wound healing using different modalities? (chart)
Only modality having evidence to support its use for wound healing?
electrical stimulation therapy
The current weight of the evidence supports the use of both LIDC and HVPC for speeding tissue healing.
–Venous ulcers
–Ischemic ulcers
–Pressure ulcers
–Burns
describe the “skin battery”
what happens to the electrical flow following a skin injury? “currents of injury” slide
Cathode = electrode from which a conventional current leaves a polarized electrical device. (This definition can be recalled by using the mnemonic CCD for cathode current departs.)
Conventional current describes the direction in which positive electronic charges move, making the cathode the positive electrode (i.e. repels +ve charges, attracts –ve charges)
Electrons have a negative charge, so the movement of electrons is opposite to the conventional current flow (electrons flow into the device’s cathode). * correction* positive is cathode!!
what is the electrical basis for Electrical Therapy Wound Healing? proposed effects?
Manipulation of the Currents of Injury
Positively charged electrode (cathode) over a wound
- Negatively charged cells and ions will be drawn toward the electrode
- Positively charged cells and ions will be repelled
Negatively charged electrode (anode) over a wound
- Positively charged cells and ions will be drawn toward the electrode
- Negatively charged cells and ions will be repelled
Cells that migrate to a positive bioelectric charge
–Neutrophils
–Macrophages
–Epidermal cells
Cells that migrate to a negative bioelectric charge
–Neutrophils (if wound infected or inflamed)
–Fibroblasts
*Different stages of repair respond to currents of different polarity
define: galvanotaxis
Galvanotaxis: the process of attracting charged cells to an electric field of opposite polarity
what are the indications of electric wound therapy?
1.Chronic wounds: most types
–Pressure ulcers
–Diabetic
–PVD (peripheral vascular disease)
2.Failure to heal using conventional care
–No clinical signs of healing after 14 days
3.PMHx of impaired healing
describe what influences the “healability” in terms of wound healing with electric therapy
1) Medical status – Anemia, malnutrition, hyperglycemia
2) Blood flow
3) Patient compliance
4) Chronicity of ulcer – Likelihood of healing decreases significantly with time
*Ankle Brachial Pressure Index (ABPI) is a measure of the fall in blood pressure in the arteries supplying the legs and as such is used to detect evidence of blockages. Normal = 0.9, abnormal below 0.8, severe PVD below 0.5)
describe High-Volt Pulsed Current (HVPC) vs Low-Intensity Direct Current (LIDC)
Low-Intensity Direct Current (LIDC)
- amplitude less than 1 mA (10–3A)
- a.k.a. microcurrent, low-volt pulsed current, microelectrical neuromuscular stimulator, or microelectrical stimulation
describe electrode placement for electrotherapy
describe the Effect of Current based on the treatment goal of electrotherapy
describe the how to conduct the electrotherapy process
* Metals usually not allowed but Silverlon ok because bound to dressing
what is the protocol for high-volt pulsed current? (in terms of frequency, intensity, and duration for the phases of healing)