Abstract
The present study investigated the effects of pulsed electromagnetic field (PEMF) on the tensile biomechanical properties of diabetic wounds at different phases of healing. Two intensities of PEMF were adopted for comparison.We randomly assigned 111 10-week-old male streptozotocin-induced diabetic Sprague-Dawley rats to two PEMF groups and a sham control group. Six-millimetre biopsy punched full thickness wounds were made on the lateral side of their hindlimbs. The PEMF groups received active PEMF delivered at 25 Hz with intensity of either 2 mT or 10 mT daily, while the sham group was handled in a similar way except they were not exposed to PEMF. Wound tissues were harvested for tensile testing on post-wounding days 3, 5, 7, 10, 14 and 21. Maximum load, maximum stress, energy absorption capacity, Young’s modulus and thickness of wound tissue were measured.On post-wounding day 5, the PEMF group that received 10-mT intensity had significantly increased energy absorption capacity and showed an apparent increase in the maximum load. However, the 10-mT PEMF group demonstrated a decrease in Young’s modulus on day 14. The 10-mT PEMF groups showed a significant increase in the overall thickness of wound tissue whereas the 2-mT group showed a significant decrease in the overall maximum stress of the wounds tissue.The present findings demonstrated that the PEMF delivered at 10 mT can improve energy absorption capacity of diabetic wounds in the early healing phase. However, PEMF (both 2-mT and 10-mT) seemed to impair the material properties (maximum stress and Young’s modulus) in the remodelling phase. PEMF may be a useful treatment for promoting the recovery of structural properties (maximum load and energy absorption capacity), but it might not be applied at the remodelling phase to avoid impairing the recovery of material properties.
Highlights
People with diabetes have difficulty in wound healing and medical interventions are required to enhance healing
In terms of wound closure, our findings were in line with those reported by other authors [13,14,15], suggesting that Pulsed electromagnetic field (PEMF) could enhance wound closure
The lower intensity of 2 mT used is comparable to the 1.2-mT and 15-Hz PEMF adopted by Callaghan et al [14] and the 5-mT and 25-Hz by our earlier study [15]
Summary
People with diabetes have difficulty in wound healing and medical interventions are required to enhance healing. Pulsed electromagnetic field (PEMF) has been used clinically as an intervention to enhance healing of chronic ulcers. Previous studies have shown that PEMF accelerated wound closure [3,4,5,6], reduced wound pain [4], enhanced healthy granulation [4] and promoted circulation [6]. In non-diabetic models, PEMF reduced wound size [8,9,10,11], resolved inflammation [11], accelerated re-epithelialization [11], promoted vascular growth [9, 11], improved fibroblast maturation [11], enhanced collagen deposition [9, 11] and increased the tensile strength [12] of cutaneous wounds
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