Estim For Wound

  1. Definition of Estim for Wounds
    • Electrial stimulation for wounds has been difined as "the use of capacitive coupled electrial circit to transfer energy to a wound"
    • Capacitively coupsed ES invoels the transfer of electric surrent through an applied surface electrode pad that is in wed contact with the external skin surface and/or wound bed
  2. Inflammatory Process
    • 3-7 days
    • Vasoconstriction followed by localized vasodilation and arrival of cells
    • Polymorphonuclear cells and macrophages
    • Process of migration of these cells to the site or injury by way of chemical signal is called chemotaxis
    • Rid he injury site of associated tissue debirs when wound is clean second phase begins
  3. Proliferative Phase
    • Formation of new blood vessels
    • Prduction of extracellular matrix: Granulation tissue
    • Main cell is the fibroblast
    • Wound Contraction
    • Epithelial cells regenerate and migrate from the margin to the center of the wound
  4. Remodeling phase
    • up to 2 yrs
    • Amount of collagen increases and gradual converstion in teh type of collagen
    • Scar becomes more organized
  5. Current within the wound
    • A flow of current with a positive polarity occures within the wound
    • Triggers wound healing
    • Associated with moist wound healing process
    • wounds that dry out cease demonstrating a post injury current
    • Possitive wound potential serves as an indictor of healing
  6. Galvonataxis
    • Describes the proceess in which cells possessing a positve or negative charge are attracted to an electrica field of opposite polarity
    • the positively or negatively charged cells taht normally response to injury may be attracted to the positvie or negative pole of the simulating electrode
  7. Postive Current
    • Attracts: O2 7 acids
    • Repels: alkalines, base metals, alkaloids
    • Tissue Changes: Harends
    • Edema: Dehydrates
    • Vasomotor: Vasocontriction
    • Produces: Ischemia
  8. Negative Current
    • Attracts: H+ and Alkalines
    • Repels: Acids, Acid radicals, hologens
    • Tissue Changes: softens
    • Edema: Hydrates
    • Vasomotor: Vasodilations
    • Produces: hypermia
  9. Antimicrobial Effects
    • ES has an bacteriocial Effect of various pathogenic organisms that are commonly found to infect wounds
    • Cathode: Pseudomonas aeruginosa
    • Staphyloccoccus aureus
    • Anode: Staphyloccus aureua
  10. Effects on Blood Flow
    • ES enhances blood circulation
    • Cirucaltory system allow oxyen and nutrients to reach tissue needed for all phases of healing
  11. Necrotic Tissue Theory
    • ES facilitates autolytic debridement via the galvanotaxis theory.
    • Positive polarity attracts negatively charged neutrophiles and macrophages to promote autolysis
    • Polar effects produce a change in Ph (alkaline) to solubilize the necrotic wound tissue - Alkaline recation occur at cathode.
  12. Indications for EStim for Wounds
    • Pressure (decubitus)
    • Venous insufficiency
    • Arteral insufficiency
    • Diabetic Wounds
  13. Contraindications/Precautions for EStim for Wounds
    • Osteomyelitis
    • Actively bleeding wounds
    • Presence of Metal Ions
    • Adverse Site Responses
  14. Types of Current Used for Wounds
    • Low insetensity direct current
    • Pulesed current HIGH VOLT PULSED CURRENT
    • Alternating Current
  15. Periwound Electrode Placement
    • Results in less current density within the wound
    • More advantageous when trying to activate sensory nerves in skin (pain control)
    • Less potential for disurbance of the wound bed
    • A reduced chance of crosscontamination between the wound and the electrodes
Card Set
Estim For Wound