Abstract
Extracorporeal shock wave therapy (ESWT) enhances tissue vascularization and neoangiogenesis. Recent animal studies showed improved soft tissue regeneration using ESWT. In most cases, deep partial-thickness burns require skin grafting; the outcome is often unsatisfactory in function and aesthetic appearance. The aim of this study was to demonstrate the effect of ESWT on skin regeneration after deep partial-thickness burns. Under general anesthesia, two standardized deep partial-thickness burns were induced on the back of 30 male Wistar rats. Immediately after the burn, ESWT was given to rats of group 1 (N = 15), but not to group 2 (N = 15). On days 5, 10, and 15, five rats of each group were analyzed. Reepithelialization rate was defined, perfusion units were measured, and histological analysis was performed. Digital photography was used for visual documentation. A wound score system was used. ESWT enhanced the percentage of wound closure in group 1 as compared to group 2 (P < 0.05). The reepithelialization rate was improved significantly on day 15 (P < 0.05). The wound score showed a significant increase in the ESWT group. ESWT improves skin regeneration of deep partial-thickness burns in rats. It may be a suitable and cost effective treatment alternative in this type of burn wounds in the future.
Highlights
Burn wounds are a response to thermic, chemical, or electric forces and, depending on the depth of the burn, acute surgical debridement of the burned skin layers may be necessary
The exact mechanisms are not perfectly known yet; experimental studies could reveal the potential of shock waves to increase growth factors, which are known to be crucial for wound healing and angiogenesis [1]
In the current study we found that the treatment with this noninvasive technique resulted in a clinical tendency towards better wound healing, shown by a significantly smaller and well-epithelialized wound area in the treatment group on day 15
Summary
Burn wounds are a response to thermic, chemical, or electric forces and, depending on the depth of the burn, acute surgical debridement of the burned skin layers may be necessary. Wounds that affect the superficial skin layers including the reticular stratum characterize deep partial-thickness burns. In contrast to full-thickness burn wounds, blood supply to the affected area is still intact. Extracorporeal shock wave therapy (ESWT) has been used for over 30 years in lithotripsy. The exact mechanisms are not perfectly known yet; experimental studies could reveal the potential of shock waves to increase growth factors, which are known to be crucial for wound healing and angiogenesis [1]. Other studies showed an increase in skin flap survival in rats or described effects improving the clinical outcome in patients with plantar fasciitis, tennis elbow, or nonunions [2,3,4,5,6]
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