diabetic-foot-ulcers

The use of Extracorporeal Shockwave Therapy for Chronic Diabetic Foot Ulcers


Etiologies of chronic diabetic foot ulcers (DFUs) are multifactorial. They are caused by angiopathy and poor skin sensation due to peripheral neuropathy.
Chou WY conducted this study at Kaohsiung Chang Gung Memorial Hospital (Kaohsiung, Taiwan). During the course of the study, a total of 21 patients were screened. Extracorporeal shockwave therapy was shown to induce neovascularization and increase angiogenic and osteogenic growth factors that lead to an improvement in blood flow perfusion and tissue regeneration.

 

Management of chronic DFUs requires a multifaceted approach, including dressings, glucose control, shoe wear, infection control, wound care, vascular and nutritional consultation and surgery in select cases.
Extracorporeal shockwave therapy (ESWT) has been shown to induce neovascularization and increase angiogenic and osteogenic growth factors that lead to an improvement in blood flow perfusion and tissue regeneration.
Chou WY conducted this study at Kaohsiung Chang Gung Memorial Hospital (Kaohsiung, Taiwan). The inclusion criteria consisted of patients with a non-healing wound, Wagner grade II or less DFUs of > 3 months’ duration and haemoglobin A1C < 12%. The exclusion criteria included patients with cardiac arrhythmia or a pacemaker, malignancy, joint sepsis, non-diabetic ulcers, multiple ulcers or a fistula, pregnant women, history of poor compliance, obesity (body mass index > 40 kg/m2), patients on dialysis and patients involved in another clinical trial.
During the course of study, a total of 21 patients were screened; only 4 patients fulfilled the criteria and 17 were excluded.
Four patient with a DFU were treated with ESWT. At 48 weeks the result showed completely healed ulcers in 2 patient and improved in other 2 patients
The results of this series showed a tendency of tissue regeneration when intermittent booster ESWT is used in DFUs.
Despite a small case number, the results showed that ESWT may be effective to heal or improve DFUs.

Chou WY, Wang CJ, Cheng JH, Chen JH, Chen CC, Kuo YR.
Wounds. 2019 May;31(5):132-136. Epub 2019 Mar 15.

Source: https://www.ncbi.nlm.nih.gov/pubmed/30990778

WhatsApp chat