Wounds that fail to heal normally are a major problem for many people with physical impairment and/or disability. These chronic wounds cause significant pain and disability and occur at an alarmingly high frequency in at-risk patient populations. Electrotherapy is the use of electrical stimulation (ES) for treatment of chronic wounds and has long been known but is not reliably effective. The proposed study will determine the physiological mechanisms for effective electrotherapy to provide complete healing of ischemic wounds and use the results of pre-clinical studies to direct rapid implementation in veterans with chronic non-healing wounds. An untethered electronic bandage with all the components of a surface stimulation system mounted on a flexible substrate has been customized for use in this study. This device, known as the Modular Stimulation System (MSS), will be used in throughout the study. A multidisciplinary team of researchers will work together to ensure that this new approach to chronic wound therapy will be highly acceptable to clinical users. Devices will be tested using procedures defined by the Advanced Platform Technology Center Design Control-Quality Systems program, prior to use in a pre-clinical animal model. The MSS will be used in a rat ischemic wound model to evaluate the electrical stimulation variables and treatment durations that will provide the best wound healing This will be defined by several criteria including low inflammation, increased angiogenesis, rapid wound closure and normal scar formation. The effective treatment of chronic wounds is integral to providing the highest standards of health care for veterans. Systematic pre-clinical evaluation of the MSS for electrotherapy of chronic wounds using a valid animal model will provide a strong foundation for effective translation from the benchtop to the bedside to provide clinical benefit for veterans with chronic wound and improve overall care.
Excellence in care is an important mission of the VA. Chronic wounds, such as ischemic wounds and pressure ulcers, are a leading cause of re-hospitalization for many veterans and are often associated with prolonged periods of hospitalization. This major secondary complication is also among the most common cause of morbidity in the patient populations cared for by the VA. Effective and reliable techniques to treat chronic wounds are integral to the goal of providing the highest standards of care for veterans. Electrical stimulation is recommended as a treatment modality for severe chronic wounds, but the underlying physiological mechanisms are not fully understood. This has limited widespread clinical implementation. Systematic evaluation of the effects of electrotherapy using a valid animal model will provide a basis for effective translation from the benchtop to the bedside and improve overall care for veterans with chronic wounds.