Authors (including presenting author) :
Yau YY(1), Pang YK(1)
Affiliation :
Stoma &Wounds Care, Queen Elizabeth Hosptial
Introduction :
Chronic wounds are significant health problems and major concern of healthcare providers because their challenging healing cascade affects patients’ physio-psycho-social aspects and escalates healthcare systems costs.
The mechanical forces generated by Extracorporeal Shock Wave therapy (ESWT) are believed to activate various cellular signaling pathways, increase the production of growth factors, cytokines, and other molecules involved in tissue repair and regeneration as mechanotransduction phenomena.
Therefore, the service enhancement was performed to observe clinical outcomes after ESWT was delivered to etiologically different chronic wounds.
Objectives :
The aim of this study was to evaluate the effect of ESWT on chronic wounds in outpatient wound care clinic setting.
Methodology :
Subjects with chronic wounds presented to the outpatient wound care clinic and were refractory to standard of care for more than 30 days were considered for ESWT. In January 2024 to December 2024, eight patients of eight persistent chronic wounds were recruited: pressure injury[n=3], venous leg ulcer[n=1], fistula wound[n=2], and surgical wound[n=2]. In eight cases, each wound underwent ESWT one session per week with 800 shockwaves impulses at 6Hz applied at 0.25Mj/mm² according to the manufacturer’s treatment protocol. Subjects were assessed by validated measure. The Bates-Jansen Wound Assessment Tool (BWAT) were performed before the ESWT application and till wound healed or total 20 times of ESWT.
Result & Outcome :
A significant wound decrease and enhance wound healing. Total five of eight wounds were healed. The minimum number of times of ESWT required for complete wound closure was11, while maximum was20 weeks. The mean number of treatment weeks was17 (+/- 4.3). Also, a substantial clinical improvement was noted in the Bates-Jansen Wound Assessment Tool(BWAT) with22.75% (+/-10.4) (p< 0.001).
The three of eight wounds(n=3, 37.5%) with pressure injury were non-healed after20 times of ESWT. There is a statistically significant reduction in wound metric parameters: a reduction in the mean wound area from 28cm3 +/-47.1 to 13.6cm3 +/-22.8(a difference of 14.4cm3, p< 0.5). Additionally, the BWAT score for Pressure injury wound(n=3) also showed a significant enhancement, improving from39.3 +/- 11.9 to 28.3 +/- 13.7(a difference of 11, p< 0.05). During ESWT treatment, the patients reported painless. Also, no complications and hospitalization arose and required from ESWT.
The ESWT application has been shown to be beneficial in chronic wounds in several studies. In this study, ESWT is a painless, noninvasive technology that has potential to reduce the cost and time associated with wound healing.
