Department of Physiotherapy, Wroclaw Medical University, Wroclaw, Poland.
Division of Anaesthetic and Surgical Nursing, Wroclaw Medical University, Wroclaw, Poland.
Clin Interv Aging. 2024 Apr 30;19:665-679. doi: 10.2147/CIA.S448298. eCollection 2024.
Extracorporeal shock wave therapy (ESWT) is a beneficial adjunct modality for chronic wounds. Limited research has been conducted on pressure ulcers (PUs), while the majority of studies have focused on diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs). This study aimed to evaluate the short-term effects of radial ESWT in older adults with chronic wounds.
This study involved a total of 31 wounds: PUs (n=22), VLUs (n=7), and DFUs (n=2). A single radial ESWT was performed with 300 + 100 shocks per cm, pressure of 2.5 bar, energy of 0.15 mJ/mm, and frequency of 5 Hz. Assessments using digital planimetry and clinical methods, utilizing the Wound Bed Score (WBS) and the Bates-Jansen Wound Assessment Tool (BWAT) were performed before the radial ESWT application (M0) and one week after (M1).
A significant wound decrease in planimetry was noted (pre-ESWT vs post-ESWT), with wound area from 9.4 cm to 6.2 cm, length from 6.4 cm to 3.9 cm, and width from 2.8 cm to 2.1 cm (p<0.001). Additionally, a substantial clinical improvement was noted in both the WBS with a 31.25% increase and the BWAT with a 20.00% increase (p<0.001). It was also found a significant correlation between the planimetric and clinical outcomes for both tools: WBS (r=-0.446, p=0.012) and BWAT (r=0.327, p=0.073).
The ESWT application yields substantial immediate clinical effects that support the healing of chronic wounds in older adults. Even a single ESWT session can prove to be clinically effective and beneficial in the management of chronic wounds.
体外冲击波疗法（ESWT）是治疗慢性伤口的有益辅助手段。虽然已经有一些研究针对压疮（PU）开展，但大多数研究都集中在糖尿病足溃疡（DFU）和静脉性下肢溃疡（VLU）上。本研究旨在评估径向 ESWT 对老年慢性伤口的短期疗效。
本研究共涉及 31 处伤口：PU（n=22）、VLU（n=7）和 DFU（n=2）。采用 300+100 次/cm 的径向 ESWT，压力为 2.5 巴，能量为 0.15 mJ/mm，频率为 5 Hz。在应用径向 ESWT 之前（M0）和之后一周（M1），使用数字平面测量法和临床方法（Wound Bed Score [WBS] 和 Bates-Jensen Wound Assessment Tool [BWAT]）进行评估。
平面测量法显示伤口显著缩小（ESWT 前与 ESWT 后），伤口面积从 9.4 cm 缩小至 6.2 cm，长度从 6.4 cm 缩小至 3.9 cm，宽度从 2.8 cm 缩小至 2.1 cm（p<0.001）。此外，WBS 增加了 31.25%，BWAT 增加了 20.00%，这表明临床状况有了显著改善（p<0.001）。两种工具的平面测量结果和临床结果之间都存在显著相关性：WBS（r=-0.446，p=0.012）和 BWAT（r=0.327，p=0.073）。
ESWT 应用可带来显著的即时临床效果，有助于老年慢性伤口的愈合。单次 ESWT 治疗即可在慢性伤口管理中显示出临床效果和益处。
