Title : Efficacy of biophysical energies on healing of diabetic wounds
Chronic wound is a common complication seen in people with diabetes, and is the leading cause of nontraumatic lower limb amputation. Diabetic polyneuropathy and microangiopathy that happens in people with diabetics may impair the wound healing process, thus the wound can get stuck in various phases of healing and eventually become a chronic non-healing wound. Early management on diabetic wounds is crucial to save the limbs from amputation. Common treatments for diabetic foot ulcers may involve surgical revascularization or frequent debridement. However, a significant proportion of diabetic foot ulcers do not heal with the conventional treatment approaches. Diabetic wounds in particular those with biofilm has been difficult to treat because of increasing antibiotic resistance. Biophysical energies have been used in clinical setting to promote diabetic wound healing. These biophysical energies include a variety of treatments ranging from electrical stimulation to the use of electromagnetic field, and extracorporeal shockwave to photo energies and ultrasound. It has been used to promote tissue repair and has been found to enhance fibroblast activity and angiogenesis. Previous studies showed promising effects of biophysical energies in treating diabetic foot ulcers. Electrical stimulation, phototherapy and ultrasound interventions have shown positive findings in promoting healing of diabetic foot ulcers in human. Moreover, based on the percentage of original wound size affected by the biophysical energies in animal studies, both pulsed electromagnetic field and low-level laser therapy demonstrated a significant clinical benefit compared to the control or sham treatment. Our research team has shown that pulsed electromagnetic field produce a favorable influence on accelerating wound closure, decreasing wound depth and increase microcirculation in people with diabetes. Pulsed electromagnetic field could also promote early wound healing and myofibroblast proliferation in diabetic animals. The results indicate potential benefits of biophysical energies in diabetic wound management.