Wound care: Aftercare and Electrophysical Treatment Mechanisms Flashcards
What is Low Level LASER/light Therapy (LLLT) and mechanism?
Provides an optimal environment for the wound to heal and ressolve tissues.
energise/wake the cells to heal the wound
Uses low intensity light to stimulate biological processes at cellular level; promote healing, repair and pain relief
Mechanism:
- Photons gets absorbed by mitochondria chromophores (cytochrome c oxidase), and create a biochemical cascade, increasing ATP production
- ATP releases: co2, reactant oxidation species, nitric oxide and calcium ions.
- Generating ROS signals stimulates cells proliferation, migration and healing.
= Promotes proliferation of fibroblast (Reactant oxidation species) & collagen synthesis (due to fibroblast prolif) - Nitric oxide increases blood flow, delivering o2 & nutrients to tissues = endothelial cell formation = angiogenesis
- Regulates pro and anti-inflammatory cytokines =
- The pro-inflammatory cytokines attract neutrophils and macrophages to the injury site to clear debris, pathogens, and damaged tissue.
- anti-inflammatory cytokines reduces inflammation and tissue repair
What is Light Emitting Diode (LED) and mechanism?
Non-coherent light Utilise low energy light to stimulate healing and tissue repair
Mechanism:
- Gets absorbed by photo receptors (like cytochrome) = increase ATP production
= Stimulates cellular activity: Promote fibroblast and collagen synthesis, keratinocytes re-epithelialisation = help cells to repair and proliferate better
- Regulates pro and anti-inflammatory cytokines =
- The pro-inflammatory cytokines attract neutrophils and macrophages to the injury site to clear debris, pathogens, and damaged tissue.
- anti-inflammatory cytokines reduces inflammation and tissue repair
What is Ultrasound Therapy and mechanism?
- Utilises high-frequency sound waves create mechanical pressure (transmission) through tissue to help tissue repair
Mechanism:
- Ultrasound wave creates mechanical pressure in tissues = influence cellular permeability and stimulate fibroblast activity
- Wound care: Cavitation effect: Create microscopic gas bubbles = improve tissue oxygenation and granulation tissue formation
- Agitates cells (;Fibroblast, macrophages, endothelial cells, keratinocytes) (& temporary breakage in the desmosomes) around wound activate them to work heal wound.
What is Transcutaneous Electrical Nerve Stimulation (TENS) and mechanism?
- Electrical therapy that delivers low voltage electrical currents through skin to control pain and modulate nerve activity.
Mechanism:
- it stimulates sensory nerves, which interferes with the transmission of pain signals to the brain (closes the gate, meaning relating to the gate control theory)
- release endogenous opioids = reduce pain
- Induce muscle contraction = promote oxygen and nutrient delivery to wound site
What is Radiofrequency/Ultra-cavitation and mechanism?
Radiofrequency energy generates heat in deep layers of skin or fat tissue = promoting tissue remodelling and cellular metabolism
Mechanism:
- RF: Create thermal effects in subcutaneous = collagen remodelling and increase local blood circulation
- Thermal and mechanical effects, breakdown fibrotic tissue and promote wound healing
- Ultra-cavitation: low-frequency ultrasound create microbubbles disrupting fat cell membrane which breaks down adipocytes (conjunction with MLD to reduce oedema
What can ultrasound therapy treat?
- Chronic wound: stimulate granulation tissue formation
- Promote tissue oxygenation, and support healing in ulcers
- Assist in the debridement of non-viable tissue
- Improve overall wound bed preparation.
What can Transcutaneous electrical nerve stimulation (TENS) treat?
Wound:
- Pain management in patients with chronic wounds
- Aid in wound healing by improving local blood flow and oxygenation of the tissues.
What can LLLT treat?
- Chronic wounds
- Diabetic ulcers and pressure injuries
- Post-surgical wound care to promote tissue repair and reduce scarring.
What can LED treat?
- Superficial wound healing
- Blue light: acne and fungal
- Minor burns
- Abrasions
- Surgical incisions
- Manage chronic skin conditions
What can radiofrequency/cavitation treat?
- Wound management: Tissue remodelling, scar reduction, and treat fibrotic tissues
- Ultra-cavitation: Lipoedema and tissue oedema.
Types of LED therapy
- 415nm blue: Dries the skin & targets acne
Woodlamp
- Acne: (fluorescing between yellow and red = orange coral) is normal oil flow (c.acne involvement)
More red = more c.acne involvement
- Fungal infection (sometimes white) = green/yellow fluorescent)
- 630nm red: Reach the superficial-papillary dermis
Suitability: Superficial wound, expansion and dilation of capillaries
Benefits: wound healing, tissue repair (fibroblast and collagen synthesis), reduce inflammation, angiogenesis - 830nm near-infrared: Reach Reticular dermis
Suitability: Deep tissue healing, pain reduction, ulcers
