Peters et al. 2001
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Peters EJ, Lavery LA, Armstrong DG, Fleischli JG. Electric stimulation as an adjunct to heal diabetic foot ulcers: a randomized clinical trial. Arch Phys Med Rehabil. 2001 Jun;82(6):721-5.
Design: Randomized, double-blind, placebo-controlled pilot trial Subjects: 40 patients with diabetic foot ulcers, consecutively sampled. Methods: 40 DFU patients randomly assigned to: 1. Treatment group (n=20): HVPC electrical stimulation every night for 8 hours. • A dose of 50V with 80 twin peak monophasic pulses per second (80Hz) was delivered for 10 minutes. This was followed by 10 minutes of 8 pulses per second (8Hz) of current. Pulse width was 100µs. 2. Placebo groups (n=20): used identical functioning units that delivered no current. Additional wound care in both groups consisted of weekly debridements, topical hydrogel, and off-loading with removable cast walkers. Patients were followed for 12 weeks or until healing, whichever occurred first. Outcomes included: Proportion of wounds that healed during the study period. Compliance rate of wound healing, and time until healing. Results: • 65% of the patients healed in the group treated with stimulation, whereas 35% healed with placebo. • After stratification by compliance, a significant difference was identified among compliant patients in the treatment group (71% healed), noncompliant patients in the treatment group (50% healed), compliant patients in the placebo group (39% healed), and noncompliant patients in the placebo group (29% healed, linear-by-linear association, p = .037). • There was no significant difference in compliance between the 2 groups.
Key message: High-voltage, pulsed galvanic electric stimulation enhances diabetic foot ulcer wound healing when used with local wound care and appropriate pressure and shear reduction.
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