References
The impact of continuous electrical microcurrent on acute and hard-to-heal wounds: a systematic review
Abstract
Background:
Wound infections result in considerable morbidity, mortality and healthcare costs. Antibiotic resistance has complicated wound healing, and new, non-antibiotic-based treatment methods are being developed.
Aims:
To evaluate evidence on the safety, efficacy and real-world effectiveness of electroceutical devices (ECDs) that provide continuous electrical stimulation to wounds.
Method:
A systematic search was conducted to identify primary studies published between 2009 and 2019 that described therapeutic wound treatment using portable ECDs. Studies were included if the ECD delivered continuous electrical current directly to the wound area for the duration of treatment.
Results:
Of 171 citations identified in the search, 13 articles met the inclusion criteria and were analysed. Nine studies evaluated dressings embedded with zinc and silver particles that generated electricity electrochemically, and four evaluated electrode-based units with external batteries. ECDs were effective in healing complex, hard-to-heal wounds that had not responded to other treatments. Four studies showed that ECDs led to complete closure of wounds without complications, and in some cases healed wounds faster than standard of care (SOC). One study found that ECDs resulted in higher ratings by both patients and surgeons than SOC for the progression of wound healing and scar appearance. Additionally, three studies found ECD treatment was less expensive than SOC, due to patients requiring fewer dressing changes or nurse visits.
Conclusion:
ECDs appeared to be a safe, effective and cost-effective method for treating severe, complex and challenging wounds, including hard-to-heal wounds, surgical incisions and skin graft donor sites.
Skin and soft tissue infections affect 14 million patients annually in the US.1 Preventing surgical site infections (SSIs) is widely recognised as a priority1,2,3 and there is a growing recognition of the need to improve hard-to-heal wound management.4,5 In Western countries, 1–2% of the population has hard-to-heal skin ulcers4 and approximately six million patients in the US require treatment for hard-to-heal wounds annually, costing over $20 billion.6 The incidence of non-healing wounds is increasing rapidly as the population ages and the prevalence of diabetes, cardiovascular disease and obesity rise.4,6
Morbidity and mortality associated with non-healing skin and soft tissue wounds are often driven by infection, especially in immunocompromised patients.1 Bacterial contamination fosters the growth of biofilms that are difficult to remove and reduce the body's ability to heal itself, and are found in more than 60% of hard-to-heal (non-healing) wounds.7,8,9
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