Shock Wave Therapy for Acute and Chronic Soft Tissue Wounds: A Feasibility Study

Wolfgang Schaden, Richard Thiele, Christine Kölpl, Michael Pusch, Aviram Nissan, Christopher E. Attinger, Mary E. Maniscalco-Theberge, George E. Peoples, Eric A. Elster, Alexander Stojadinovic*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

155 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1-12
Number of pages12
JournalJournal of Surgical Research
Volume143
Issue number1
DOIs
StatePublished - Nov 2007
Externally publishedYes

Keywords

  • extracorporeal shock wave therapy
  • soft tissue wounds

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