Review Efficacy and theoretical basis of low-intensity shock wave therapy in the management of different forms of wound healing – own experiences and a review of the literature

Abstract

Objectives: Wound healing is a complex process that involves inflammation, proliferation, and tissue remodeling to restore damaged tissue integrity. Chronic wounds and ulcers, with incomplete healing and a high risk of recurrence, pose significant challenges to conventional treatments. Extracorporeal Shock Wave Therapy (ESWT) has emerged as a promising wound healing therapy. Material and Methods: In this review, we summarize the current state of ESWT for wound management based on personal experiences and a comprehensive literature review. Among 184 data sources from 1990 to 2022, 19 relevant publications were identified, including systematic reviews, meta-analyses, and clinical studies applying focused and radial ESWT for various wound types. Results: ESWT's mechanism of action involves generating focused or radial shock waves, stimulating tissue repair through angiogenesis, fibroblast proliferation, and collagen expression. Data extracted from systematic reviews showed positive outcomes for wound healing, healing rate, and wound area reduction for chronic wounds such as diabetic foot ulcers, pressure ulcers, and venous ulcers. Studies on radial ESWT revealed similar positive effects in pain reduction and wound healing, with no serious adverse events reported. ESWT exhibited a well-tolerated safety profile, with minor and transient side effects such as reddening, swelling, and mild pain at the treatment site. Comparatively, Hyperbaric Oxygenation Therapy (HBO), an alternative treatment option, showed unique adverse events not observed with ESWT. Our evaluation confirms ESWT as a safe and effective treatment for wound management, offering hope for patients with chronic wounds or ulcers. Conclusions: ESWT presents a compelling non-invasive and safe treatment option for various wound healing challenges, improving outcomes for patients with chronic wounds and ulcers. This review highlights the potential of ESWT as an advanced wound healing therapy, complementing conventional approaches. Further studies should explore potential differences between focal and radial ESWT for wound healing.