Physical medicine modalities most frequently applied in the lower limbs chronic wounds treatment in Poland

Abstract

Abstract Introduction Chronic wounds are the ones that present no healing progress for more than three months. The most common reasons for the chronic wound development in the lower limbs include long-lasting diabetes mellitus, venous insufficiency and peripheral arterial disease. However, it is estimated that 15%–20% of the lower limb chronic wounds are of mixed etiology. Standard treatments such as pharmacotherapy, debridement or skin grafting may be supplemented with physical medicine modalities. Aim The aim of the paper was to indicate the utility and biological effects of the physical medicine modalities frequently applied in chronic wound treatment. Discussion The physical medicine modalities widely used in the lower limbs chronic wounds treatment are variable magnetic fields, low-level laser therapy and hyperbaric oxygen therapy. Those modalities are proved to stimulate various biological reactions which may promote chronic wound healing. Stimulation of angiogenesis and collagen proliferation are factors that promote histological wound maturation and closure. Local circulation improvement mediated by hypocoagulation and vasodilatation is a factor accelerating wounds healing. Modalities-mediated pain reduction is a result of anti-inflammatory activity as well as of endogenous endorphin secretion. Modalities-mediated bacteriostatic and bactericidal effects are also observed. All those effects are mediated by activation of the immune system. An anti-inflammatory effect is due to the inhibition of pro-inflammatory cytokines secretion and the increase in interleukins activity. Conclusions Variable magnetic fields, low-level laser therapy and hyperbaric oxygen therapy are modalities revealing various working mechanisms. The significance of their administration in chronic wounds treatment can be attributed to a variety of their biological effects.