Abstract

Background and Purpose. Only 3% of the U S population is afflicted by diabetes, yet one of the most common chronic wounds is the diabetic ulcer. Decrease in blood flow may be one reason why only 31% of neuropathic diabetic ulcers heal in 20-weeks. The purpose of this investigation was to compare healing rates and blood flow of chronic stage III and IV wounds in people with diabetes and those without diabetes over four weeks of treatment. Blood flow was measured before, during, and after stimulation using one of two different electrical stimulation waveforms in a 32°C room.

Subjects. Forty subjects with chronic stage III and IV wounds were treated at an outpatient wound center. Twenty of these subjects had diabetes and twenty subjects were without diabetes.

Methods. Treatment consisted of electrical stimulation with a biphasic waveform at a pulse width of 250 μsec or a monophasic waveform at 250 μsec for 30-minutes at a current of 10-20 milliamps using disposable electrodes. The subjects were seen for four weeks and treated three times per week. Testing was performed at the 1st, 6th and 12th treatment. Blood flow was measured by a Laser Doppler Imager before, during, and after electrical stimulation. All testing and treatment was conducted in a 32°C room (+/- 5°C).

Results. A “carryover effect” was seen from prestimulation of the initial evaluation to the prestimulation of the 2nd week test. The increase in blood flow was greater for subjects with diabetes (an increase 140 +/-31.5 flux units) than for subjects free of diabetes (an increase of 48 +/-44.8 flux units) at the outside of the wound. Increased blood correlated to percent healing rates over four weeks up to 70% in subjects with diabetes using biphasic current and 45% using monophasic current.

Discussion and Conclusion. Increased blood flow was observed in both groups, for both currents, and at the outside, edge and center of the wounds Healing rates may be increased in subjects with diabetes and chronic wounds by using a 32°C room and electrical stimulation with either biphasic or monophasic waveforms.

Key Words: Chronic wounds, blood flow, electrical stimulation

LLU Discipline

Physical Therapy

Department

Physical Therapy Sciences

School

School of Allied Health Professions

First Advisor

Jerrold S. Petroisky

Second Advisor

Everett Lohman III

Third Advisor

Ernie Schwab

Fourth Advisor

Michael S. Laymon

Degree Name

Doctor of Physical Therapy (DPT)

Degree Level

Ph.D.

Year Degree Awarded

2005

Date (Title Page)

6-2005

Language

English

Library of Congress/MESH Subject Headings

Electric Stimulation Therapy; Electrodes -- therapeutic use; Physical Therapy -- methods; Wounds and Injuries; Wound Healing

Type

Thesis

Page Count

vii; 41

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

Download

Share

COinS