TY - JOUR
T1 - Shock Wave Therapy for Acute and Chronic Soft Tissue Wounds
T2 - A Feasibility Study
AU - Schaden, Wolfgang
AU - Thiele, Richard
AU - Kölpl, Christine
AU - Pusch, Michael
AU - Nissan, Aviram
AU - Attinger, Christopher E.
AU - Maniscalco-Theberge, Mary E.
AU - Peoples, George E.
AU - Elster, Eric A.
AU - Stojadinovic, Alexander
PY - 2007/11
Y1 - 2007/11
N2 - Background: Nonhealing wounds are a major, functionally-limiting medical problem impairing quality of life for millions of people each year. Various studies report complete wound epithelialization of 48 to 56% over 30 to 65 d with different treatment modalities including ultrasound, topical rPDGF-BB, and composite acellular matrix. This is in contrast to comparison control patients treated with standard wound care, demonstrating complete epithelialization rates of 25 to 39%. Extracorporeal shock wave therapy (ESWT) may accelerate and improve wound repair. This study assesses the feasibility and safety of ESWT for acute and chronic soft-tissue wounds. Study design: Two hundred and eight patients with complicated, nonhealing, acute and chronic soft-tissue wounds were prospectively enrolled onto this trial between August 2004 and June 2006. Treatment consisted of debridement, outpatient ESWT [100 to 1000 shocks/cm2 at 0.1 mJ/mm2, according to wound size, every 1 to 2 wk over mean three treatments], and moist dressings. Results: Thirty-two (15.4%) patients dropped out of the study following first ESWT and were analyzed on an intent-to-treat basis as incomplete healing. Of 208 patients enrolled, 156 (75%) had 100% wound epithelialization. During mean follow-up period of 44 d, there was no treatment-related toxicity, infection, or deterioration of any ESWT-treated wound. Intent-to-treat multivariate analysis identified age (P = 0.01), wound size ≤10 cm2 (P = 0.01; OR = 0.36; 95% CI, 0.16 to 0.80), and duration ≤1 mo (P < 0.001; OR = 0.25; 95% CI, 0.11 to 0.55) as independent predictors of complete healing. Conclusions: The ESWT strategy is feasible and well tolerated by patients with acute and chronic soft tissue wounds. Shock wave therapy is being evaluated in a Phase III trial for acute traumatic wounds.
AB - Background: Nonhealing wounds are a major, functionally-limiting medical problem impairing quality of life for millions of people each year. Various studies report complete wound epithelialization of 48 to 56% over 30 to 65 d with different treatment modalities including ultrasound, topical rPDGF-BB, and composite acellular matrix. This is in contrast to comparison control patients treated with standard wound care, demonstrating complete epithelialization rates of 25 to 39%. Extracorporeal shock wave therapy (ESWT) may accelerate and improve wound repair. This study assesses the feasibility and safety of ESWT for acute and chronic soft-tissue wounds. Study design: Two hundred and eight patients with complicated, nonhealing, acute and chronic soft-tissue wounds were prospectively enrolled onto this trial between August 2004 and June 2006. Treatment consisted of debridement, outpatient ESWT [100 to 1000 shocks/cm2 at 0.1 mJ/mm2, according to wound size, every 1 to 2 wk over mean three treatments], and moist dressings. Results: Thirty-two (15.4%) patients dropped out of the study following first ESWT and were analyzed on an intent-to-treat basis as incomplete healing. Of 208 patients enrolled, 156 (75%) had 100% wound epithelialization. During mean follow-up period of 44 d, there was no treatment-related toxicity, infection, or deterioration of any ESWT-treated wound. Intent-to-treat multivariate analysis identified age (P = 0.01), wound size ≤10 cm2 (P = 0.01; OR = 0.36; 95% CI, 0.16 to 0.80), and duration ≤1 mo (P < 0.001; OR = 0.25; 95% CI, 0.11 to 0.55) as independent predictors of complete healing. Conclusions: The ESWT strategy is feasible and well tolerated by patients with acute and chronic soft tissue wounds. Shock wave therapy is being evaluated in a Phase III trial for acute traumatic wounds.
KW - extracorporeal shock wave therapy
KW - soft tissue wounds
UR - http://www.scopus.com/inward/record.url?scp=35348925582&partnerID=8YFLogxK
U2 - 10.1016/j.jss.2007.01.009
DO - 10.1016/j.jss.2007.01.009
M3 - Article
C2 - 17904157
AN - SCOPUS:35348925582
SN - 0022-4804
VL - 143
SP - 1
EP - 12
JO - Journal of Surgical Research
JF - Journal of Surgical Research
IS - 1
ER -