Do electrical stimulation enhance pressure ulcer healing in people living with spinal cord injuries: a meta-analysis and systematic review of randomised and non-randomised controlled trials

Liu, Liang Q. ORCID: https://orcid.org/0000-0002-6358-1637, Moody, Julie and Gall, Angela (2015) Do electrical stimulation enhance pressure ulcer healing in people living with spinal cord injuries: a meta-analysis and systematic review of randomised and non-randomised controlled trials. In: 25th Conference of the European Wound Management Association (EWMA 2015), 13-15 May 2015, ExCeL London, UK. . [Conference or Workshop Item]

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Abstract

Aim: To quantitatively analyse the effect of ES on PrU healing compared with standard wound care (SWC) and/or sham stimulation.

Method: Review was limited to peer-reviewed studies published in English from 1970 to May 2014. Studies included randomized controlled trials (RCTs) and non-RCTs. Methodological quality was assessed using established instruments. Pooled analyses were performed to calculate mean difference (MD) for continuous data, odds ratio (OR) for dichotomous data.

Results / Discussion: Eight prospective controlled studies were reviewed, five studies were RCTs, and three studies were non-RCTs. Pooled analyses of eight trials showed ES significantly improved daily healing rate (MD 0.89, 95% CI 0.23-1.55, p=0.008) with significant heterogeneity. Pulsed current ES significantly improved daily healing rates compared with constant direct current (DC) or alternating current (AC) in two trials (MD 1.50, 95% CI 0.62, 2.39, p=0.0009, I2=81%). Pooled analysis of two trials showed significant higher numbers of ulcer healed (OR 2.95, 95% CI 1.69–5.17, p=0.0002, I2=0%) with ES treatment. There was a trend towards less number of ulcer worsened with ES treatment (OR 0.38, 95% CI 0.12–1.24, p=0.11, I2=18%).intervals (CI).

Conclusion: ES can significantly enhance PrU healing in SCI according to limited level I evidence. Pulsed current ES may confer better benefit on PrU healing than DC or AC. Electrodes placed on wound bed maybe superior to those applied on the intact skin.

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