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Electrical Stimulation Therapy Increases Rate of Healing of Pressure Ulcers in Community-Dwelling People With Spinal Cord Injury

      Abstract

      Houghton PE, Campbell KE, Fraser CH, Harris C, Keast DH, Potter PJ, Hayes KC, Woodbury MG. Electrical stimulation therapy increases rate of healing of pressure ulcers in community-dwelling people with spinal cord injury.

      Objective

      To investigate whether electric stimulation therapy (EST) administered as part of a community-based, interdisciplinary wound care program accelerates healing of pressure ulcers in people with spinal cord injury (SCI).

      Design

      Single-blind, parallel-group, randomized, controlled, clinical trial.

      Setting

      Community-based home care setting, Ontario, Canada.

      Participants

      Adults (N=34; mean age ± SD, 51±14y) with SCI and stage II to IV pressure ulcers.

      Interventions

      Subjects were stratified based on wound severity and duration and randomly assigned to receive either a customized, community-based standard wound care (SWC) program that included pressure management or the wound care program plus high-voltage pulsed current applied to the wound bed (EST+SWC).

      Main Outcome Measures

      Wound healing measured by reduction in wound size and improvement in wound appearance at 3 months of treatment with EST+SWC or SWC.

      Results

      The percentage decrease in wound surface area (WSA) at the end of the intervention period was significantly greater in the EST+SWC group (mean ± SD, 70±25%) than in the SWC group (36±61%; P=.048). The proportion of stage III, IV, or X pressure ulcers improving by at least 50% WSA was significantly greater in the EST+SWC group than in the SWC group (P=.02). Wound appearance assessed using the photographic wound assessment tool was improved in wounds treated with EST+SWC but not SWC alone.

      Conclusions

      These results demonstrate that EST can stimulate healing of pressure ulcers of people with SCI. EST can be incorporated successfully into an interdisciplinary wound care program in the community.

      Key Words

      List of Abbreviations:

      CCAC (community care access center), EST (electrical stimulation therapy), PSST (pressure sore status tool), PWAT (photographic wound assessment tool), SCI (spinal cord injury), SWC (standard wound care), WSA (wound surface area), % ↓ WSA (percentage wound surface area reduction from baseline)
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