The Effect of Monophasic Vs. Biphasic Current on Healing Rate and Blood Flow in People With Pressure and Neuropathic Ulcers

Abstract

Background: Endothelial dysfunction due to diabetes may be one reason why at least 15% of people with diabetes will eventually develop a lower extremity ulcer with delayed healing and risk of amputation. Recent evidence shows that skin blood flow may be increased with electrical stimulation if treatment is done in a warm room. However, optimal stimulation waveform is unknown. Optimizing the stimulation waveform may increase healing even more. The purpose of this investigation was to compare two electrical waveforms to determine which increased blood flow blood flow and wound healing more in chronic stage III or IV pressure ulcers and in Wagner stage II neuropathic ulcers when using a warm room. Materials and Methods: Forty subjects with chronic pressure or neuropathic ulcers were treated at an outpatient wound center. Twenty were people with neuropathic ulcers and twenty with pressure ulcers. Treatment consisted of biphasic or monophasic electrical stimulation up to 20 mA for 30 minutes, 3x/ week for 4 weeks in a 32°C room. Skin blood flow was measured by a Laser Doppler imager. Results: Subjects with neuropathic ulcers receiving biphasic current had significantly higher healing rate (70.0% ± 32.3%) than those receiving. monophasic current (42% ± 22.3%; p Conclusion: Both patients with neuropathic and pressure ulcers receiving biphasic current demonstrated greater blood flow and healing rates compared with patients receiving monophasic current when treated in a 32°C room.