THE EFFECTIVENESS OF ELECTRICAL STIMULATION THERAPY ON CHRONIC WOUNDS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background: Chronic diseases are a global health burden that requires immediate attention. The ageing population sets precedence to an array of chronic diseases, which are risk factors for chronic wounds. Electrical stimulation therapy (EST) have been used extensively in fields of psychiatry and chronic pain management. With advancements in technology, EST have also been tested in the field of chronic wound management, with notable benefits. Aims: The present review aims to evaluate-the clinical efficacy-of EST on chronic wounds and examine its effectiveness in its implementation into clinical guidelines. Methods: An extensive literature search has been conducted in The Cochrane Library, PubMed, EMBASE, CINAHL, PsycINFO, ProQuest Thesis and Dissertation and other trial registries for randomised controlled trials (RCTs). The search was based of the concepts: ‘chronic wounds’ and ‘electrical stimulation therapy’. Meta-analyses were performed using the RevMan software. Heterogeneity was measured using the I2 and ?2 values, and the overall effect was evaluated with the Z-statistics. Quality of studies and certainty of evidence was appraised using the risk of bias tool from Cochrane and GRADE respectively. Results: A total of 4462 articles were examined, and 11 articles were included into this review, for a total of 515 participants, ranging from 5 countries. EST was found to increase proportion of completely healed wounds by 4.30 times more than placebo or standard wound care (SWC). It also decreases wound area by 1.54% and increases percentage area reduction by 16.16%, as compared to placebo or SWC. Conclusion and implications: EST benefits chronic wounds and enhances chronic wound closure, but current evidence is insufficient to justify clinical implementation. The implications of this research is that future research must adopt a high methodological quality, as well as more researches should be done to look into the qualitative impact of EST on chronic wound patients.