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.