High-voltage electric stimulation of the donor site of skin grafts accelerates the healing process. A randomized blinded clinical trial

• Published in: Burns Vol. 44; no. 3; pp. 636 - 645
• Main Authors: Gomes, Rosana C., Guirro, Elaine C.O., Gonçalves, Adriana C., Farina Junior, Jayme A., Murta Junior, Luiz O., Guirro, Rinaldo R.J.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-05-2018
• Subjects: Adult; Burns; Burns - surgery; Cicatrix - etiology; Double-Blind Method; Electric Stimulation Therapy - methods; Electrical stimulation; Female; Humans; Male; Middle Aged; Pain, Postoperative - physiopathology; Physiotherapy; Re-Epithelialization; Scalp - surgery; Skin Transplantation - methods; Thigh - surgery; Transplant Donor Site; Wound Healing; Young Adult; Electrical stimulation; Wound healing; Burns; Physiotherapy
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2017.10.006

•High-voltage current reduced pain at donor site.•High-voltage current accelerated the healing process.•High-voltage current improved the quality of the scar formed.
Severe burns benefit from skin grafting, and grafting surgery is of great importance in the treatment of these injuries. As a result, there is formation of an additional wound at the donor site, which is painful and susceptible to infection. However, the therapeutic approach to these problems at donor sites for skin grafting is insufficiently explored in the literature.
To evaluate electrical stimulation of the donor sites of burn patients treated by grafting surgery.
This work evaluated 30 donor sites of cutaneous graft burn patients treated with high-voltage electrical stimulation. Subjects were randomized into two groups: electrical stimulation (GES), treated with electrostimulation (50min, 100Hz, twin pulses 15 us, monophasic), and the sham group (GS), treated by the same procedures but without current. Pain was assessed by visual analog scale daily before and after the electrical stimulation. The time elapsed until complete epithelization was evaluated (time of primary dressing detached spontaneously). Skin temperature was measured by thermography. The characteristics of donor sites were qualitatively evaluated using images and the plug-in CaPAS® (Carotid Plaque Analysis Software).
The results showed a significant decrease in pain, which was absent on the third day in the GES and the sixth day in the GS. The time the primary dressing detached spontaneously in days decreased (p<0.05) (4.7±0.2) compared to the GS group (7.0±1.3). Donor site healing characteristics such as vascularization, pigmentation, height, the quantity of crust formed, irregularities, and the quality of healing was better in the GES; moreover, homogeneity and inertia of the images confirmed higher healing quality.
As a result of the study, the technology shows promise and merits a larger study with objective assessments and different physical variables.