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Electrical Stimulation for Wound-Healing: Simulation on the Effect of Electrode Configurations.

ABSTRACT: Endogenous electric field is known to play important roles in the wound-healing process, mainly through its effects on protein synthesis and cell migration. Many clinical studies have demonstrated that electrical stimulation (ES) with steady direct currents is beneficial to accelerating wound-healing, even though the underlying mechanisms remain unclear. In the present study, a three-dimensional finite element wound model was built to optimize the electrode configuration in ES. Four layers of the skin, stratum corneum, epidermis, dermis, and subcutis, with defined thickness and electrical properties were modeled. The main goal was to evaluate the distributions of exogenous electric fields delivered with direct current (DC) stimulation using different electrode configurations such as sizes and positions. Based on the results, some guidelines were obtained in designing the electrode configuration for applications of clinical ES.

SUBMITTER: Sun YS

PROVIDER: S-EPMC5401728 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Electrical Stimulation for Wound-Healing: Simulation on the Effect of Electrode Configurations.

Sun Yung-Shin YS

BioMed research international 20170409

Endogenous electric field is known to play important roles in the wound-healing process, mainly through its effects on protein synthesis and cell migration. Many clinical studies have demonstrated that electrical stimulation (ES) with steady direct currents is beneficial to accelerating wound-healing, even though the underlying mechanisms remain unclear. In the present study, a three-dimensional finite element wound model was built to optimize the electrode configuration in ES. Four layers of th ...[more]

PMID: 28497054

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Project description:PurposeMacrophage accumulation in response to decreasing myonuclei may be the major mechanism underlying immobilization-induced muscle fibrosis in muscle contracture, an intervention strategy suppressing these lesions is necessary. Therefore, this research investigated the effect of belt electrode-skeletal muscle electrical stimulation (B-SES), a new electrical stimulation device, to the macrophage accumulation via myonuclei decrease in immobilization-induced muscle fibrosis.Materials and methods18 Wistar male rats were divided into the control group, immobilization group (with plaster cast fixation to immobilize the soleus muscles in a shortened position for 2 weeks), and B-SES group (with muscle contractile exercise through B-SES during the immobilization period). B-SES stimulation was performed at a frequency of 50 Hz and an intensity of 4.7 mA, muscle contractile exercise by B-SES was applied to the lower limb muscles for 20 minutes/session (twice a day) for 2 weeks (6 times/week). The bilateral soleus muscles were used for histological, immunohistochemical, biochemical, and molecular biological analyses.ResultsThe number of myonuclei was significantly higher in the B-SES group than in the immobilization group, and there was no significant difference between the B-SES and control groups. The cross-sectional area of type I and II myofibers in the immobilization and B-SES groups was significantly lower than that in the control group, and the cross-sectional area of type I myofibers in the B-SES group was higher than that in the immobilization group. However, Atrogin-1 and MuRF-1 mRNA expression in the immobilization and B-SES groups was significantly higher than those in the control group. Additionally, the number of macrophages, IL-1β, TGF-β1, and α-SMA mRNA expression, and hydroxyproline expression was significantly lower in the control and B-SES groups than those in the immobilization group.ConclusionThis research surmised that muscle contractile exercise through B-SES prevented immobilization-induced muscle fibrosis, and this alteration suppressed the development of muscle contracture.

Project description:Angiogenesis is critical for wound healing. Insufficient angiogenesis can result in impaired wound healing and chronic wound formation. Electrical stimulation (ES) has been shown to enhance angiogenesis. We previously showed that ES enhanced angiogenesis in acute wounds at one time point (day 14). The aim of this study was to further evaluate the role of ES in affecting angiogenesis during the acute phase of cutaneous wound healing over multiple time points. We compared the angiogenic response to wounding in 40 healthy volunteers (divided into two groups and randomised), treated with ES (post-ES) and compared them to secondary intention wound healing (control). Biopsy time points monitored were days 0, 3, 7, 10, 14. Objective non-invasive measures and H&E analysis were performed in addition to immunohistochemistry (IHC) and Western blotting (WB). Wound volume was significantly reduced on D7, 10 and 14 post-ES (p = 0.003, p = 0.002, p<0.001 respectively), surface area was reduced on days 10 (p = 0.001) and 14 (p<0.001) and wound diameter reduced on days 10 (p = 0.009) and 14 (p = 0.002). Blood flow increased significantly post-ES on D10 (p = 0.002) and 14 (p = 0.001). Angiogenic markers were up-regulated following ES application; protein analysis by IHC showed an increase (p<0.05) in VEGF-A expression by ES treatment on days 7, 10 and 14 (39%, 27% and 35% respectively) and PLGF expression on days 3 and 7 (40% on both days), compared to normal healing. Similarly, WB demonstrated an increase (p<0.05) in PLGF on days 7 and 14 (51% and 35% respectively). WB studies showed a significant increase of 30% (p>0.05) on day 14 in VEGF-A expression post-ES compared to controls. Furthermore, organisation of granulation tissue was improved on day 14 post-ES. This randomised controlled trial has shown that ES enhanced wound healing by reduced wound dimensions and increased VEGF-A and PLGF expression in acute cutaneous wounds, which further substantiates the role of ES in up-regulating angiogenesis as observed over multiple time points. This therapeutic approach may have potential application for clinical management of delayed and chronic wounds.

Dataset Information

Electrical Stimulation for Wound-Healing: Simulation on the Effect of Electrode Configurations.

Publications

Electrical Stimulation for Wound-Healing: Simulation on the Effect of Electrode Configurations.

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