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Διεθνείς Δημοσιευσεις - ePlastry

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Electrical stimulation of wound
methology
discussion
conclusion
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Eplasty. 2008; 8: e28.
Published online 2008 May 16.
PMCID: PMC2396465
Low-intensity Electrical Stimulation in Wound Healing: Review of the Efficacy of Externally Applied Currents Resembling the Current of Injury
Konstantine C. Balakatounis and Antonios G. Angoules
School of Health and Social Care, Oxford Brookes University, England, United Kingdom;
Filoktitis Medical Center (Center of Excellence in Physical Medicine and Rehabilitation), Athens, Greece; and
Academic Unit of Orthopaedic Surgery and Trauma, Leeds Teaching Hospitals, Leeds, England, United Kingdom
Correspondence: Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
DEFINITION AND TECHNICAL SPECIFICATIONS
 
Low-intensity electric currents or microcurrents (MCs) are currents of an intensity less than or equal to 1 mA (1000 μA, μA = microampere). The current may be direct or alternating of varying—mainly rectangular—waveforms, frequency, and pulse duration. Low-intensity currents were formerly known as MC electrical neuromuscular stimulators, but were later named microcurrent electrical stimulator (MES) (MC electrical stimulator).2
Microcurrents are produced by low-voltage generators or combined electrotherapy units. Such generators or units can produce a range of waveforms, from monophasic to square or rectangular biphasic, with a range of frequencies from 0.3 to 50 Hz. Electrotherapeutic units of low voltage may produce currents of intensities up to a few milliamperes in which case sensory stimulation or muscular stimulation results. Pulse duration may also be modified from 1 to 500 milliseconds at low frequencies or may be preselected when pulsed current is utilized.2
 
CURRENT OF INJURY
 
In 1843, Dubois-Reymond reported a current of an intensity of 1-mA exiting human skin wounds. It was later confirmed that wounds create a surrounding electric field, the “current of injury,” which was found to be of an intensity less than 1 mA.3,4 The current of injury extends up to a radius of 2–3 mm around the wound, and the gradient gradually decreases from 140 mV/mm to 0 mV/mm.5,6 It also appears that the transportation of Na+ into the cell, through the cell membrane, maintains skin “battery” of a potential difference of 20 to 40 mV, the negative pole being outside the cell.
It has been supported that the current of injury can be maintained if a moist occlusive dressing is applied, but will gradually decrease if the wound is left open and unprotected.6,7 As the wound heals, the current of injury is also reduced.6
By considering that healing appears to be promoted through the use of occlusive dressings,8,9 which retain the current of injury within the wound environment, it can be and has been postulated10 that the current of injury plays a significant role in wound healing.11 Therefore, it can be claimed that LIC may resemble the natural electric field/current created following injury, thus enhancing a complex biological mechanism of wound healing.12 One of those mechanisms is galvanotaxis. Galvanotaxis can be defined as the directional migration of various types of cells,13,14 such as endothelial cells,15 and keratinocytes, thus enhancing reepitheliazation.16,17 The biological processes underlying galvanotaxis are under investigation, 1 proposed mechanism being lateral electrophoresis resulting in changes in the plasma membrane and possibly affecting protein redistribution.11