A new system from a company in Israel was cleared by the Food and Drug Administration to use electricity and ultrasound to heal chronic and deep wounds.The new system is called BRH-A2 by BRH Medical that utilizes both electric fields and ultrasound energy to treat wounds and reduce pain.The device has different frequencies and strength ranges of energy stimulations to cover a wide array of treatments.It can also track the progress of the treatment and measure ulcers.

"The BRH-A2 system has a patent protected measuring software to measure the ulcer size, even though the edges of chronic ulcers are not clearly defined due to loss of tissue.The system also features a state of the art user-friendly interface and stores clinical data of thousands of patients on an individual patient's filing system and database," according to the company's website.

Electricity on Wound Healing

Electrical stimulation is now an option to speed up wound healing, and it can be used on patients suffering from heart conditions, diabetes, paralysis or arthritis.Proper use of electrical stimulation on wounds is safer compared with medications because the technology only targets the area instead of releasing chemicals in the body.The stimulation provides several benefits when applied as wound healing accelerator.

- Increases the fibroblast production.Fibroblasts are common cells in connective tissues responsible for maintaining the integrity of connective tissue structure.These cells produce several proteins, such as collagens, glycosaminoglycans, and glycoproteins that are important to wound healing.Fibroblasts also initiate inflammation to a tissue injury after detecting pathogens.That initiation summons the immune cells to clear out invading microbes.

- Increases the speed of cell migration.Cell migration is a process found in the development and maintenance of organisms with multiple cells.The process is an orchestrated performance of several cells responding to an injury to repair broken tissues.It involves the platelet-derived growth factor to induce cell growth and division and formation of new blood vessels.

- Speeds up the formation of new blood vessels.The right amount of electrical frequency, amplitude, and pulse duration encourages blood flow and stimulates blood vessels, according to a study published in March 2017.

- Decreases bacterial burden on wounds.Electrical stimulation has been found with bacteriostatic and bactericidal potentials.The bacteriostatic effect prevents the growth of bacteria while the bactericidal effect kills the microorganism, according to a study in 2014.

"Although electrical stimulation may appear to many of us as the 'new kid on the block,' it is a technology that has significant research underpinning it that we should all be aware of.We should also be prepared to keep our minds open and review our current practice while considering using this technology in managing patients with hard-to-heal complex wounds," said Keith Harding, a professor at the Rehabilitation Medicine and Wound Healing at Wounds International.

Therapeutic effects of ES have been discovered by several research studies, including the management of overactive bladder symptoms in 20 patients by the researchers at Pittsburgh University, and the reawakening of physical sensations on a paralyzed man using a prosthetic hand conducted by the researchers at the Defense Advanced Research Projects Agency.

Ultrasound on Wound Healing

The therapeutic model of ultrasound was used since the 1940s by physical therapists to promote wound healing.The vibration caused by the ultrasound provides several positive effects to a patient:

- Relaxes the surrounding tissues.

- Improves blood circulation of the area.

- Breaks down scar tissues.

- Reduces inflammation.

- Promotes healing of bone fractures.

- Decreases the amount of pain.

It can also be used by clinicians to administer drugs to patients uncomfortable with injections.One example is the delivery of a drug called cortisone through the skin using ultrasound to reduce inflammation.Other health conditions that can be treated by ultrasound include muscle spasms, inflammation of the tendons, non-acute joint swelling, and Peyronie's disease.In Peyronie's disease, the ultrasound breaks down scar tissues or plaques that form inside the male reproductive organ.

Side Effects of Electrical Stimulation and Ultrasound Therapy

Electrical stimulation therapy is generally favored by most patients requiring care for wound healing.In a study led by Dr.Katharina Herberger at the University of Hamburg in Germany, revealed that 74 percent of the participants described EST as "good" or "very good." About 48.1 percent of the participants described it as "good" while 29.1 percent told that EST was "very good." Overall participants of about 78.5 percent were satisfied with the tolerability of EST.However, the study discovered adverse effects directly connected with EST such as skin reactions to the electrode, irritation of the skin surrounding the wound site, and softening of tissues caused by the liquid action called maceration.

Ultrasound therapy typically lasts up to five minutes and may extend depending on the size of the area.The ultrasound probe is constantly moving during treatment and will not cause any discomfort to the patient.However, holding the probe for more than a few seconds on the area may cause discomfort as sound energy accumulates.The accumulation may also cause minor breaks on the bone close to the surface area.