Published Scientific Literatureon High Voltage Pulsed Current

From Aletha W. Tippett, M.D.

Excerpt By C. Sussman

“ when discussing electrical stimulation it is important to distinguish the waveforms”

“HVPC from controlled studies is most thorough and consistent.” “HVPC has safe current because of its short pulse duration which prevents significant changes in both tissue PH and temperature”.

Sussman, C. and Byl, N. Electrical Stimulation for Wound Healing, Wound Care Collaborative Practice Manual for Physical Therapists and Nurses, Aspen Publishers 1998. Chapt. 16.

Electrical Stimulation For Wound Healing

Types of Electrical Stimulation

Four Groups1. Low intensity direct current (LIDC)2. Alternate current (AC) 3. Trancutaneous electrical nerve

stimulation (TENS) 4. High voltage pulse current (HVPC)

Bioelectric System

The body has its own bioelectric system. This system influences wound healing by attracting the cells of repair, changing cell membrane permeability, enhancing cellular secretion through cell membranes, and orientating cell structures.

A current termed the "current of injury" is generated between the skin and inner tissues when there is a break in the skin. The current will continue until the skin defect is repaired. Healing of the injured tissue is arrested or will be incomplete if these currents no longer flow while the wound is open. A moist wound environment is required for the bioelectric system to function.

A rationale for applying electrical stimulation is that it mimics the natural current of injury and will jump start or accelerate the wound healing process.

Inflammation phase Initiates the wound repair process by its effect on the current of injury

Increases blood flow Promotes phagocytosis

Enhances tissue oxygenation Reduces edema perhaps from reduced microvascular leakage

Attracts and stimulates fibroblasts and epithelial cells Stimulates DNA synthesis

Controls infection ( Note: HVPC proven bacteriocidal at higher intensities than

use in clinic and may not be tolerated by patient) Solubilizes blood products including necrotic tissue

Proliferation phase Stimulates fibroblasts and epithelial cells

Stimulates DNA and protein synthesis Increases ATP generation

Improves membrane transport Produces better collagen matrix organization,

Stimulates wound contraction Epithelialization phase

Stimulates epidermal cell reproduction and migration Produces a smoother, thinner scar

Electrical Stimulation and Infection— Staphylococcus aureus

• Published in JRRD , volume 4, number 2, Mr/Ap 2004 by Merriman, H ; Hegyi, C

• Abstract suggests for infected wounds HVPC has significant bacterial inhibitory effect that may contribute to enhanced wound healing rates (but at higher powers than usually used clinically).

From Unpublished Study

University Health Sciences CenterOklahoma City, Oklahoma

With Dr. Jefferey Davis at MicroVas

How does this therapy work?• Electromagnetic stimulation

– Causes muscle contraction– Stimulates circulation, direct and indirect– Increases tissue perfusion– Cell membrane effects?– Increases tissue metabolism

• Increased oxygen tension in tissue– Muscle contraction—muscle pump and increased

circulation– Direct effect– Cellular effects?

Increased Tissue Perfusion

Forced Exercise2 Pump TheoryInvoluntary Muscle ContractionIncreased Oxygenation

• Typical Results:– After 1 treatment Up 48% – Baseline-8 weeks Up 58%– Best baseline-8 wks Up 157%

Mechanism of Action

Direct tissue stimulation

• Skin: Increased fibroblasts, epithelialization

• Bone: Increased osteoblasts, calcium, and fracture healing

• Muscle: Increased tone, growth

• Connective Tissue: Increased strength

Mechanism of Action