Of late, when it comes to wound care, there is more and more discussion around shockwave…it is increasingly in the spotlight as a veritable game-changer in this challenging arena. In recent years, ESWT has been proven as a safe and efficacious treatment modality in wound healing.
This, of course, is welcome news for patients impacted by the physical, emotional, and psychological distress that accompanies problematic non-healing wounds. The successful use of ESWT is of great value and importance to the medical professionals managing these unique patients and their care.
Clinical and therapeutic approaches to wound care are typically quite limited in terms of options and efficacy. Standard techniques include surgical and non-surgical debridement (using enzymes) in tandem with applying special dressings and following moist wound care protocols.
The usefulness of ESWT in wound healing was discovered by happenstance in 2004 at Trauma Hospital Meidling, Vienna. While treating osteoarthritis in a patient with shockwave, healing of an accompanying fistula was also achieved.
ESWT in Wound Care Treatment
It’s vital for doctors to be aware of the possibilities and advantages of using Extracorporeal Shockwave Therapy to treat a variety of cutaneous pathologies.
Shockwave encourages tissue regeneration and is favorable in the treatment of problematic skin lesions, sores, and wounds, including:
- Skin burns
- Neuropathic ulcers
- Diabetic ulcers
- Decubitus ulcers (bed sores, pressure sores)
- Post-surgical wounds
- Trauma wounds
- Skin grafts, skin flaps, and more
Shockwave is known to induce the stimulation of growth factors which facilitates the tissue repair cascade. It’s easy to see that the tissue regeneration capability makes ESWT especially suitable in wound care settings.
What is a Chronic Wound?
The hallmark of a chronic wound is a lack of visible signs of healing within three months and is further indicated if it has not spontaneously healed by 12 weeks. Such wounds are characterized as having tissue defects, including loss of skin integrity caused by either external trauma to the area or an underlying disease.
These types of wounds are common in patients with the following diseases and occurrences:
- Vascular disease
- Metabolic conditions such as diabetes
- History of long-term pressure (bed sores)
- Infection or irritation may also be a consideration
Multidisciplinary evaluations may be necessary to evaluate and assess the wound for proper treatment. Patients may be treated in the primary care setting as well as by specialty-trained wound care medical professionals in the fields of general and vascular surgery, podiatry, and dermatology.
Four elements are considered to systematically approach and assess chronic wounds and help clinicians manage them better, and it is referred to by the acronym TIME.
T – Tissue management
I – Assess infection/inflammation
M – Moisture Balance
E – Epithelial edge advancement
Each of the above categories needs to be addressed to optimize healing potential and deliver successful wound closure.
Appropriate therapy can be initiated only after a thorough wound evaluation. Typically, low-energy shockwave treatment is applied to the wound area. Notably, to date, no treatment-related side effects have been reported in treating patients with wounds.
Shockwave is contraindicated for patients with cardiac bypass, coagulation disorders, epilepsy, pregnancy, presence of tumor tissue, brain tissue, or lung tissue in the focus area.
Wound Healing of Neuropathic Ulcers and Diabetic Ulcers
Shockwave therapy has proven clinically effective in multiple trials and modulates cellular repair and inflammatory response. Pre- and post-treatment images are quite remarkable; the visible tissue regeneration is nothing short of outstanding.
For a scientific deep dive, explore two clinical studies with the highest level of supportive evidence.
- “The management of neuropathic ulcers of the foot in diabetes by shock wave therapy” by Moretti, B. et al, was published in Biomed Central. In it, researchers concluded that concerning neuropathic diabetic ulcers, historically, patients faced the stark reality of possible amputation. Shockwave is a medical disrupter that significantly improves outcomes and makes healing possible.
- “Extracorporeal shockwave therapy in diabetic foot ulcers” by Wang, C, et al., in The International Journal of Surgery. Their findings demonstrate that shockwave therapy is more effective in treating chronic diabetic foot ulcers than hyperbaric oxygen therapy. ESWT is an innovative, new, safe, and effective treatment for chronic wounds.
- Consider adding this Level 10 volume to your medical library as it offers thorough coverage of the topic of wound care “ESWT in Aesthetic Medicine. Burns & Dermatology”
ESWT in Burn Rehabilitation
The challenges that burn patients face cannot be understated. Here is a list of some of what they face in recovery:
- Severe pain and itching during rehabilitation therapy
- Pain and itching during wound healing with dressings or skin graft surgery
- Increasing pain and itching manifest due to the persistent appearance of burn scars
- Hypertrophic scars impact mobility in joints, especially after intense rehabilitation
Extracorporeal Shockwave Therapy is used to treat these problematic symptoms of hypertrophic scars, facilitate wound healing, and have the added benefit of anti-fibrotic effects. By delivering shockwaves to burn scar tissue, microscopic injury brings about the breakup of collagen fibers, which triggers the modeling of the scars.
Help Patients Heal FASTER by Integrating ESWT into Your Plan of Care
Whether you are treating wounds, pain, or musculoskeletal conditions, your patients want to heal faster, and ESWT makes that possible. Shockwave is a medical practice game-changer that enables medical professionals to offer a higher level of care, which is non-invasive and requires no downtime.
Optimal patient outcomes and increased ROI are common goals shared by dedicated physicians and medical specialists worldwide. And evidence-based medical technologies like ESWT, EPAT, and EMTT equip practitioners to achieve that and more.
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