Extracorporeal Shockwave Therapy for Chronic Venous Ulcers: A Randomized Controlled Trial

Parisa Taheri, Morteza Shahbandari, Mehrnoosh Parvaresh, Babak Vahdatpour, Parisa Taheri, Morteza Shahbandari, Mehrnoosh Parvaresh, Babak Vahdatpour

Abstract

Background: Chronic venous ulcers (CVUs), demanding specialized care, are still a major socioeconomic problem facing health care systems worldwide. This study's main goal was evaluating the efficacy of ESWT application as an AT in the treatment of wounds for curing CVUs.

Materials and methods: 50 patients presenting with CVUs were divided into two groups of ESWT and control randomly. Then, ESWT was applied one session per week, during four weeks, along with routine CB. The control group also received sham ESWT together with CB. In this respect, pain score, wound size, patient satisfaction and quality of life (QoL) using the Charing Cross Venous Ulcer Questionnaire (CCVUQ) were consequently assessed at baseline, week four, and week eight and then compared between both groups.

Results: The findings showed that patients receiving ESWT along with CB had significantly lower pain and were also feeling more satisfied than the cases undergoing CB alone (P<0.05). The significant efficiency of ESWT in improving the healing process of CVUs was further observed (P<0.05). In addition, QoL, assessed by the CCVUQ, was significantly higher in patients receiving ESWT (P<0.05).

Conclusion: These findings established that ESWT was a feasible and safe option to treat patients presenting with CVUs in another word,ESWT seems to be a safe and effective adjunct therapy (AT) compared with CB in patients with CVUs.

Keywords: Chronic Venous Ulcer; Compression Bandaging; Extracorporeal Shockwave Therapy.

Copyright© 2021, Galen Medical Journal.

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References

    1. O&apos;donnell-Tf Jr, Lau J. A systematic review of randomized controlled trials of wound dressings for chronic venous ulcer. J Vasc Surg. 2006;44(5):1118–1143.
    1. Phillips P, Lumley E, Duncan R. A systematic review of qualitative research into people's experiences of living with venous leg ulcers. J Adv Nurs. 2018;74(3):550–63.
    1. Meulendijks AM, Welbie M, Tjin Epm, Schoonhoven L, Neumann Ham. A qualitative study on the patient's narrative in the progression of chronic venous disease into a first venous leg ulcer: a series of events. Br J Dermatol. 2020;183(2):332–371.
    1. Abreu GC, Camargo Jr OD, Abreu MF, Aquino JL. Ultrasound-guided foam sclerotherapy for chronic venous disease with ulcer. A prospective multiple outcome cohort study. J Vasc Bras. 2020;19
    1. Marston WA, Kirsner RS, Tallis A. Economic benefit of a novel dual-mode ambulatory compression device for treatment of chronic venous leg ulcers in a randomized clinical trial. J Vasc Surg Venous Lymphat Disord. 2020;8(6):1031–1071.
    1. Gupta S, Andersen C, Black J. Management of Chronic Wounds: Diagnosis, Preparation, Treatment, and Follow-up. Wounds. 2017;29(9):19–36.
    1. Weller CD, Buchbinder R, Johnston RV. Interventions for helping people adhere to compression treatments for venous leg ulceration. Cochrane Database Syst Rev. 2016;3(3):3.
    1. Mittermayr R, Antonic V, Hartinger J. Extracorporeal shock wave therapy (ESWT) for wound healing: technology, mechanisms, and clinical efficacy. Wound Repair Regen. 2012;20(4):456–65.
    1. Hess CL, Howard MA, Attinger CE. et al. A review of mechanical adjuncts in wound healing: hydrotherapy, ultrasound, negative pressure therapy, hyperbaric oxygen, and electrostimulation. Ann Plast Surg. 2003;51(2):210–218.
    1. Qureshi AA, Ross KM, Ogawa R, Orgill D. Shock wave therapy in wound healing. Plast Reconstr Surg. 2011;128(6):721–728.
    1. Cooper B, Bachoo P. Extracorporeal shock wave therapy for the healing and management of venous leg ulcers. Cochrane Database Syst Rev. 2018;6(6)
    1. Schaden W, Thiele R, Kölpl C. Shock wave therapy for acute and chronic soft tissue wounds: a feasibility study. J Surg Res. 2007;(1):1–12.
    1. Zhang L, Fu XB, Chen S, Zhao ZB, Schmitz C, Weng CS. Efficacy and safety of extracorporeal shock wave therapy for acute and chronic soft tissue wounds: A systematic review and meta-analysis. Int Wound J. 2018;15(4):590–599.
    1. Martini L, Giavaresi G, Fini M, Borsari V, Torricelli P, Giardino R. Early effects of extracorporeal shock wave treatment on osteoblast-like cells: a comparative study between electromagnetic and electrohydraulic devices. J Trauma. 2006;61(5):1198–206.
    1. Wolff KS, Wibmer A, Pusch M. The influence of comorbidities and etiologies on the success of extracorporeal shock wave therapy for chronic soft tissue wounds: midterm results. Ultrasound Med Biol. 2011;37(7):1111–1120.
    1. Saggini R, Figus A, Troccola A, Cocco V, Saggini A, Scuderi N. Extracorporeal shock wave therapy for management of chronic ulcers in the lower extremities. Ultrasound Med Biol. 2008;34(8):1261–71.
    1. Schaden W, Thiele R, Kölpl C. Shock wave therapy for acute and chronic soft tissue wounds: a feasibility study. J Surg Res. 2007;143(1):1–12.
    1. Stieger M, Schmid JP, Bajrami S, Hunziker T. Extrakorporale Stoßwellentherapie eines komplizierten chronischen Ulcus cruris venosum [Extracorporeal shock wave therapy as a treatment of a non-healing chronic leg ulcer] Hautarzt. 2013;64(6):443–6.
    1. Omar MT, Alghadir A, Al-Wahhabi KK, Al-Askar Ab. Efficacy of shock wave therapy on chronic diabetic foot ulcer: a single-blinded randomized controlled clinical trial. Diabetes Res Clin Pract. 2014;106(3):548–54.
    1. Zhang L, Weng C, Zhao Z, Fu X. Extracorporeal shock wave therapy for chronic wounds: A systematic review and meta-analysis of randomized controlled trials. Wound Repair Regen. 2017;10625(4):697–706.
    1. Smith JJ, Guest MG, Greenhalgh RM, Davies AH. Measuring the quality of life in patients with venous ulcers. J Vasc Surg. 2000;31(4):642–651.
    1. Crichton N. Visual analogue scale (VAS) J Clin Nurs. 2001;10(5):706–712.
    1. Krokowicz L, Cwykiel J, Klimczak A, Mielniczuk M, Siemionow M. Pulsed acoustic cellular treatment induces expression of proangiogenic factors and chemokines in muscle flaps. J Trauma. 2010;69(6):1448–56.
    1. Ma HZ, Zeng BF, Li XL. Upregulation of VEGF in subchondral bone of necrotic femoral heads in rabbits with use of extracorporeal shock waves. Calcif Tissue Int. 2007;81(2):124–155.
    1. Asheghan M, Hashemi SE, Hollisaz MT, Roumizade P, Hosseini SM, Ghanjal A. Dextrose prolotherapy versus radial extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: A randomized, controlled clinical trial. Foot Ankle Surg. 2020;S1268-7731(20):30176–4.
    1. Cwykiel JM, Klimczak A, Krokowicz L, Siemionow M. Pre-and postischemic pulsed acoustic cellular expression conditioning modulates expression of inflammation factors in cremaster ischemia/reperfusion injury model. Microsurgery. 2013;33(2):134–174.
    1. Weihs AM, Fuchs C, Teuschl AH. Shock Wave Treatment Enhances Cell Proliferation and Improves Wound Healing by ATP Release-coupled Extracellular Signalregulated Kinase (ERK) Activation. J Biol Chem. 2014;289(39):27090–104.

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