23.5 Electrical stimulation therapy to promote wound closure: a meta-analysis       

Pamela E. Houghton, BScPT, PhD; M. Gail Woodbury, PhD; University of Western Ontario

The objective of this study was to search, appraise, and summarize the evidence for electrical stimulation therapy (EST to accelerate the closure of chronic ulcers.) Electronic databases and bibliography searches were used to find articles published before October 2006. Inclusion criteria consisted of controlled clinical trials that had a between-group statistical comparison, a study population of adult humans, with chronic skin ulcer(s) who underwent EST treatment using surface electrodes and wound size was assessed objectively before and after treatment. Consensus between 4 independent reviewers was required to reject articles. Of 2,265 articles that were reviewed, 19 studies were included in this review that involved a total subject number of 888 (EST group = 522; Control = 366). 12 of the studies had data to support that EST accelerated wound healing while 7 studies found no differences between EST and control groups. Data was pooled from 5 studies that assessed the proportion of completely healed ulcers. Overall effect size in favor of EST treatment was 3.93; P < 0.0006. Studies that tended to show the better responses to EST included those that used randomization, large sample sizes (n = 25), had similar subject characteristics at baseline, pressure ulcers, or using EST parameters including a monophasic pulsed current, negative or alternating polarity, a relatively high pulse frequency (64 Hz). This evidence provides strong support that EST can significantly improve the proportion of chronic wounds healed.