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Published on: August 2, 2024
Randomized control of extracorporeal shock wave therapy versus placebo for chronic decubitus ulceration
Anna M Larking1, Sophie Duport, Michael Clinton
1Institute of Neuropalliative Rehabilitation, Royal Hospital for Neuro-disability, West Hill, Putney, London, UK.
Insights
Extracorporeal shock wave therapy (ESWT) shows promise for healing chronic decubitus ulcers. This study found improved healing rates in patients receiving ESWT for static chronic ulcers.
Area of Science:
- Regenerative Medicine
- Dermatology
- Biomedical Engineering
Background:
- Chronic decubitus ulcers pose a significant challenge in patients with neurological disabilities.
- Current treatment modalities for chronic wounds have limitations.
- Investigating novel therapeutic approaches is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of extracorporeal shock wave therapy (ESWT) in accelerating the healing of chronic decubitus ulceration.
- To determine if ESWT can increase the rate of wound closure in a specific patient population.
Main Methods:
- A double-blind, randomized, cross-over study design was employed.
- Participants included patients with chronic neurological conditions and decubitus ulcers.
- Ulcers were treated with either ESWT or a placebo, followed by a crossover period.
Main Results:
- Nine ulcers across eight patients were analyzed.
- A notable improvement in healing was observed 6-8 weeks after initiating ESWT.
- Healing occurred regardless of whether ESWT or placebo was administered first.
Conclusions:
- Extracorporeal shock wave therapy demonstrates potential as a therapeutic option for chronic skin ulceration.
- ESWT may offer a new avenue for managing difficult-to-heal wounds.
- Further research could explore optimal ESWT parameters for wound healing.
Objective:
To assess whether extracorporeal shock wave therapy increases the rate of healing in chronic decubitus ulceration.
Design:
Double-blind randomized cross-over study.
Setting:
A large, long-stay hospital specializing in the management of people with complex neurological disabilities.
Subjects:
The total population of available patients with chronic neurological conditions and chronic decubitus ulceration who met the inclusion criteria.
Interventions:
Ulcers were randomized into receiving either the extracorporeal shock wave therapy or the placebo for a four-week period, followed by a two-week 'washout' period followed by a four-week period of the cross-over treatment/ placebo.
Main Measures:
Measurement of the area of the ulceration. For each observation the average of three measurements were taken.
Results:
Nine ulcers (in eight patients) were included in the study: five on the buttocks/sacrum/trochanter and four on the feet/ankles. All those with static chronic ulcers showed improved healing starting 6-8 weeks after the start of extracorporeal shock wave therapy, whether treated first with the placebo or the therapy.
Conclusions:
Extracorporeal shock wave therapy has a potential part to play in the treatment of chronic skin ulceration.
