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. 2006 Apr 15;332(7546):900–903. doi: 10.1136/bmj.332.7546.900

Table 3.

Non-surgical approaches that have been advocated for treating chronic wounds

Type Mechanism of action/principle Wound type Evidence; current status
Radiant heat dressing Improves tissue oxygenation and increases subcutaneous oxygen tension Mainly postoperative wounds; diabetic ulcers; pressure ulcers Limited evidence; not in routine use
Ultrasound therapy Mechanical effect causing micromassage of tissue; anti-inflammatory effect (due to reduction in macrophages) Pressure ulcers and VLU Limited evidence; not in routine use
Laser Stimulates fibroblast activity and collagen metabolism; promotes neovascularisation; inhibits inflammation VLU, diabetic ulcers, and burns Limited evidence; not in routine use
Hydrotherapy Form of mechanical debridement; removes loosely attached devitalised tissue and other cellular debris from wound bed Pressure ulcers, VLU, and other chronic wounds containing excess slough or necrotic tissue Practised in USA, but not well established in UK
Electrotherapy Stimulates body's endogenous bioelectric system by delivering therapeutic levels of electric current into wound TENS* is used to treat some ischaemic ulcers, diabetic foot ulcer, and pressure ulcers Limited evidence; TENS* used in specialist centres
Electromagnetic therapy Promotes cytokine synthesis in the topically applied mononuclear cells (autologous) Ischaemic ulcers, pressure ulcers, and VLU Limited evidence; not in routine use

VLU = venous leg ulcer.

*

Form of electrotherapy.