Physical modalities in wound management: UVC, therapeutic heating and electrical stimulation

In spite of efforts to create an optimum wound environment for healing, there are times that a wound may not heal, may heal very slowly, or may worsen. In these cases, a series of treatments with an appropriate physical agent can be added to the patient's care plan to augment tissue reparative processes. Three modalities that have received support in the literature for use in wound healing are ultraviolet "C" radiation (UVC), therapeutic heating, and electrical stimulation. Treatment goals for UVC are hyperplasia and enhanced re-epithelialization or desquamation of the leading edge of periulcer epidermal cells, granulation tissue formation, sloughing of necrotic tissue, and bactericidal effects. Treatment goals for therapeutic heating are increased blood perfusion with subsequent increased delivery of oxygen to the tissues (avoiding the dessication of wound tissues). The treatment goal for electrical stimulation is to attract negatively or positively charged cells into the wound area, such as neutrophils, macrophages, epidermal cells and fibroblasts that in turn will contribute to wound healing processes by way of their individual cellular activities.