Site Information

Increasing Local Circulation to Achieve Wound Healing

Blood circulation is the flow of blood through the body. The blood is responsible for carrying nutrients to the cells and removing waste, both of which are required to maintain healthy tissue.

Beneficial Results:

  • Increased wound and injury healing
  • Healing of diabetic decubitus ulcers
  • More effective delivery of pharmaceutical agents
  • Edema/swelling reduction and elimination
  • Prevention of blood clot formation
  • Decreased rehabilitation time

 INCREASING LOCAL CIRCULATION TO ACHIEVE WOUND HEALING

WARNING: This program is not recommended with
other electrical stimulation units.

This Publication is to assist physicians, practitioners and
other medical personnel in developing a treatment program.

This is not for general distribution.

Copyright© 1996 Tom Oliver

ELECTRICAL STIMULATION IN HEALING
WOUNDS ON DIABETIC PATIENTS–
OVERVIEW

PROGRAM GOAL

To ascertain the effectiveness of electrical stimulation on wounds in limbs of Diabetic patients with extreme complications.

PARAMETERS

All patients are adult on set Diabetics. All patients have severe infection and lack of circulation in one or more feet. All patients have been scheduled for amputation of the limb involved. A Medical Doctor will be supervising the program. One neuromuscular electronic stimulator unit will be used (the Neurocare™ 1000 4P/XP). The method of treatment with this modality will be according to the Neurocare™ Protocol©.

OVERVIEW

Each patient is of Mexican descent. Patients are referred by the Social Security hospitals in Mexico City, Mexico.

Though patients have individual wound location, they are similar in that the wounds are all located on the feet. Four patients are followed in this particular group.

The patients in this group are all of limited economic resources which generally contributes to the rapid progression due to complications. All patients have been treated previously with conventional methods, for long periods, without success. Financial resources is a major factor in why the “system” is wanting to acquire a more economical and efficacious treatment for these individuals.

Prior to entering this program, patient’s blood sugar was only checked weekly (at best) and they received little or no counseling as to diet or hygiene. The medical community is disheartened when presented with these patients and their complications due to diabetes. In fact, in 1996 one hospital treating 75 patients with diabetic foot, amputated 95% of the patient’s limbs.

CLINIC SETTING

All treatments in the clinic are supervised by a physician. Dr. Jorge E. Ahedo is the physician in charge. Regular monitoring of patient’s glucose levels, antibiotics are given (if necessary), plus daily wound cleaning is done by a professional (usually a nurse). To insure consistency in treatment, the hospital Chief of Staff is also monitoring the program.

Patients must:

      1. Be on time for their appointments (each patient received two 45-minute treatments per day)
      2. Obey dietary restrictions
      3. Home hygiene (changing sheets, elevating the bed, changing socks daily, following instructions on personal care, etc.)

TREATMENT RESULTS

Patient results can be seen by the pictures in the following pages. These patients have all benefited through education (instruction on their illness and methods of proper hygiene). Patients have become more aggressively involved in their proper cleaning methods. All wounds were healed. And the patients were directed to the free classes at Eli Lilly to continue their education in self-care.

CONCLUSION

Even though the patient’s benefited by learning how to maintain diet and clean wounds, the wounds were not healing with conventional means. What apparently made the difference is the use of the Neurocare™ 1000 4P/XP. By increasing the circulation to the diseased limb, not only did the wounds heal, but sensitivity returned.

The treatment program using the Neurocare™ 1000 4P/XP and its designated protocols are extremely successful in increasing localized circulation even when there are extreme complications and disease factors involved.

PATIENT INTAKE PROCEDURE

      1. Introduce the patient to the therapy and explain their responsibility. If they do not comply they will not be allowed to continue with the therapy program. Patient’s family members or primary caregiver were also interviewed to assure their understanding of the importance of compliance. Because some of the clinics are closed on Sunday, the wound cleaning was to be done at home. In those cases the doctor trains them in the necessary procedure.
      2. Patient signs a release form.
      3. A complete patient history is taken. If their blood sugar has not been monitored on a daily basis, the doctor writes the necessary prescription. He also checks their medication (antibiotics, diuretics) to determine if they are being taken as prescribed.
      4. Take photos.
      5. Progress is reported on a daily report.

NOTE: Each patient has his/her own set of electrodes to prevent spread of infection or re-infection.

 


Diabetic Treatment


When most people think of diabetes, they usually concern themselves with the dietary repercussions of shifting insulin levels. In truth, diabetes has a far greater effect on a patient’s health, including the possibility of severe nerve damage. Although such damage can occur at any time during the onset of diabetes, it typically gets worse over the length of the condition if left untreated. Diabetic neuropathies can lead to a variety of symptoms, such as numbness, tingling sensations, pain or even loss of control over a limb. In fact, these neuropathies are even capable of affecting vital organs, interfering with digestion, sexual function and cardiovascular activity. Studies have shown that upwards of 50 percent of individuals suffering from diabetes will also suffer from some form of associated neuropathy. With a lack of sensation in the limbs and extremities, diabetic patients are often susceptible to foot ulcers. If these wounds are left untreated, infection can set in, leading to greater complications. In fact, diabetes is single-handedly the number-one cause of non-traumatic lower extremity amputations in the country. It is therefore imperative for diabetic individuals, or their family members, to take a proactive approach when dealing with the condition. Electric stimulation of the muscles is an effective way to battle the negative effects of diabetic neuropathy. The Neurocare™ 1000 4P/XP offers patients an FDA-registered device that can be used at home and is capable of effectively stimulating the affected muscles with minimal discomfort for the patient. In tests, the Neurocare™ 1000 4P/XP was shown to make a significant difference in patient recovery by increasing blood flow and sensitivity. As important as diet and hygiene may be, the addition of the Neurocare™ 1000 4P/XP is even effective for patients suffering from extreme complications. To contact a clinician, call 503-371-6605 or 888-671-6605 toll free, or e-mail ems@neurocare.com.

ELECTRICAL STIMULATION IN HEALING WOUNDS ON DIABETIC PATIENTS — OVERVIEW

PROGRAM GOAL: To ascertain the effectiveness of electrical stimulation on wounds in limbs of Diabetic patients with extreme complications.

PARAMETERS: All patients are adult on set Diabetics. All patients have severe infection and lack of circulation in one or more feet. All patients have been scheduled for amputation of the limb involved. A Medical Doctor will be supervising the program. One neuromuscular electronic stimulator unit will be used (the Neurocare™ 1000 4P/XP). The method of treatment with this modality will be according to the Neurocare™ Protocol©.

OVERVIEW: Each patient is of Mexican descent. Patients are referred by the Social Security hospitals in Mexico City, Mexico. Though patients have individual wound location, they are similar in that the wounds are all located on the feet. Four patients are followed in this particular group. The patients in this group are all of limited economic resources which generally contributes to the rapid progression due to complications. All patients have been treated previously with conventional methods, for long periods, without success. Financial resources is a major factor in why the “system” is wanting to acquire a more economical and efficacious treatment for these individuals. Prior to entering this program, patient’s blood sugar was only checked weekly (at best) and they received little or no counseling as to diet or hygiene. The medical community is disheartened when presented with these patients and their complications due to diabetes. In fact, in 1996 one hospital treating 75 patients with diabetic foot, amputated 95% of the patient’s limbs.

CLINIC SETTING: All treatments in the clinic are supervised by a physician. Dr. Jorge E. Ahedo is the physician in charge. Regular monitoring of patient’s glucose levels, antibiotics are given (if necessary), plus daily wound cleaning is done by a professional (usually a nurse). To insure consistency in treatment, the hospital Chief of Staff is also monitoring the program. Patients must:

  1. Be on time for their appointments (each patient received two 45-minute treatments per day)
  2. Obey dietary restrictions
  3. Home hygiene (changing sheets, elevating the bed, changing socks daily, following instructions on personal care, etc.)

TREATMENT RESULTS: Patient results can be seen by the pictures in the following pages. These patients have all benefited through education (instruction on their illness and methods of proper hygiene). Patients have become more aggressively involved in their proper cleaning methods. All wounds were healed. And the patients were directed to the free classes at Eli Lilly to continue their education in self-care.

CONCLUSION: Even though the patient’s benefited by learning how to maintain diet and clean wounds, the wounds were not healing with conventional means. What apparently made the difference is the use of the Neurocare™ 1000 4P/XP. By increasing the circulation to the diseased limb, not only did the wounds heal, but sensitivity returned. The treatment program using the Neurocare™ 1000 4P/XP and its designated protocols are extremely successful in increasing localized circulation even when there are extreme complications and disease factors involved.

PATIENT INTAKE PROCEDURE:

  1. Introduce the patient to the therapy and explain their responsibility. If they do not comply they will not be allowed to continue with the therapy program. Patient’s family members or primary caregiver were also interviewed to assure their understanding of the importance of compliance. Because some of the clinics are closed on Sunday, the wound cleaning was to be done at home. In those cases the doctor trains them in the necessary procedure.
  2. Patient signs a release form.
  3. A complete patient history is taken. If their blood sugar has not been monitored on a daily basis, the doctor writes the necessary prescription. He also checks their medication (antibiotics, diuretics) to determine if they are being taken as prescribed.
  4. Take photos.
  5. Progress is reported on a daily report.

NOTE: Each patient has his/her own set of electrodes to prevent spread of infection or re-infection.


Studies

Diabetic Extremity Wounds: Overview Case Study 1 Case Study 2 Case Study 3 Case Study 4

Gangrene and Bedsores: Wet Gangrene Dry Gangrene Bedsores 1 Bedsores 2


Diabetic Extremity Wounds:

Case Study 1

MEXICAN STUDY ON DIABETICS WITH WOUNDS ON THE EXTREMITIES PATIENT #1

PATIENT: Juan Manuel is a 53 year old, Mexican male.

DIAGNOSIS: At 47 years old (1991) he was diagnosed with Diabetes.

WOUND DESCRIPTION/HISTORY: His problem began with a small cut that was infected by “black water”. The wound would close, but the infection continued to spread. The ulcer continued to grow until it penetrated a hole from the sole of the foot through to the top of the foot.

PROGNOSIS PRIOR TO TREATMENT: He was scheduled for amputation above the knee.

TREATMENT: Began treatment on November 4, 1996. Within four (4) days there was evidence of granulation. When he went to the clinic for his treatment, the nurse noticed she could no longer pass gauze through the ulcer (top to bottom of the foot). The “passage” had closed. As shown in the photos, the top is completely closed and the bottom is about 95%.

TREATMENT SCHEDULE: Two 45 minute treatment each day until granulation is seen. Granulation was seen between treatment 6 and 7. Treatments were continued twice a day for an additional ten (10) days. Treatments were then continued at one (1) time per day. Healing continues and will be continued until wound is completely healed.

November 4, 1996
Nov 18, 1996
December 3, 1996
December 18, 1996
Dec. 27, 1996
Dec. 27, 1996
Jan. 4, 1996
Feb 4, 1997
Feb 1997

Studies

Diabetic Extremity Wounds: Overview Case Study 1 Case Study 2 Case Study 3 Case Study 4

Gangrene and Bedsores: Wet Gangrene Dry Gangrene Bedsores 1 Bedsores 2


Case Study 2

MEXICAN STUDY ON DIABETICS WITH WOUNDS ON THE EXTREMITIES PATIENT #2

PATIENT: Jose Luis Mendoza is a 62 year old, Mexican male.

DIAGNOSIS: Type II, adult-on-set Diabetic.

HISTORY/WOUND DESCRIPTION: Patient has had two toes amputated. The ulcer is on the heel of his right foot. As seen in the picture, his entire foot is effected by lack of circulation. His heel shows signs of callusing due to supporting his entire weight on the back of his heel.

TREATMENT: Began treatment on November 13, 1996. Granulation was seen within three (3) days. Treatments were given twice a day, 45 minutes each treatment. After granulation was seen, treatment was continued for and additional ten (10) days. At completion of the ten days, he was started on once a day treatments. The goal is to bring the level of the wound to the level of the foot. Doctors are considering removing the callous from the heel now that the circulation is sufficiently improved and there is less danger of problems in healing. On January 6, the wound has been reduced approximately 60%.

November 22, 1996 January 6, 1997

Studies

Diabetic Extremity Wounds: Overview Case Study 1 Case Study 2 Case Study 3 Case Study 4

Gangrene and Bedsores: Wet Gangrene Dry Gangrene Bedsores 1 Bedsores 2


Case Study 3

MEXICAN STUDY ON DIABETICS WITH WOUNDS ON THE EXTREMITIES PATIENT #3

PATIENT: Dolores is 58 year old Mexican female.

DIAGNOSIS: A Type II Diabetic for 18 years.

HISTORY/WOUND DESCRIPTION: Patient entered the hospital in May of 1996 for treatment of infection in a diabetic ulcer on her left foot. The doctors opened the wound to “look for infection”. By 11/16/96 her ulcer had progressed so drastically that the bone in her heel was exposed. She was scheduled for amputation.

TREATMENT: Treatment was begun on 11/19/96, receiving two 45-minute treatments per day. Granulation was seen on the morning of the fourth day. Healing was hindered slightly by an E-coli infection in the plantar section of her foot. This infection was contracted in her home due to improper cleaning procedures. (She had a cold and was unable to come into the clinic for the cleaning of the wound.) The infection was treated with specific antibiotics and has been eliminated. Continuing with two treatments a day, the bone on the heel has covered over and the flap on the plantar section has closed. She is now considered a good candidate for a graft due to the vast improvement in her circulation.

November 16, 1996
November 16, 1996
November 29, 1996

Studies

Diabetic Extremity Wounds: Overview Case Study 1 Case Study 2 Case Study 3 Case Study 4

Gangrene and Bedsores: Wet Gangrene Dry Gangrene Bedsores 1 Bedsores 2


Case Study 4

MEXICAN STUDY ON DIABETICS WITH WOUNDS ON THE EXTREMITIES PATIENT #4

PATIENT: Salvador is a 50 year old Mexican male.

DIAGNOSIS: Type II Diabetic for 18 years.

HISTORY/WOUND DESCRIPTION: Patient has had an ulcer on his right leg which took six months to heal. He was hospitalized with that problem for two of the six months. He then burned both of his feet on hot cement. The burns became infected and he was hospitalized for 28 days. The left foot healed during his hospital stay. However, infection continued to reoccur in his right foot. In September of 1996, he had two toes amputated. The wound left from amputation was still sizable after two months.

TREATMENT: He began treatment with the Neurocare™ Treatment Program© on November 4, 1996. Received treatments twice a day until granulation appeared (4th day) and his wound decreased in size from 11.5 cm X 9.5 cm. On January 2, 1997 the wound measures 3 X 2.5 cm. He is now a candidate for a skin graft due to his improved circulation in his foot.

November 4, 1996
January 2, 1997
November 4, 1996
November 11, 1996
December 11, 1996
December 20, 1996

Studies

Diabetic Extremity Wounds: Overview Case Study 1 Case Study 2 Case Study 3 Case Study 4

Gangrene and Bedsores: Wet Gangrene Dry Gangrene Bedsores 1 Bedsores 2


Wet Gangrene

PATIENT: 63 year old male.

DIAGNOSIS: Adult on-set Diabetic, kidney failure and on dialysis, neuropathy and microangiopathy, wet gangrene in three toes and dry gangrene from mid tibia distally.

HISTORY: Patient was taken off antibiotics three days before this treatment started. Patient was scheduled for amputation.

TREATMENT: Patient was put on antibiotic treatment and the Neurocare™ treatment was done three (3) times a day for the first week. Two times a day for the next two weeks.

PROGRESS: The wet gangrene reduced to the tip of the large toe and turned very hard by the end of the first week. By day ten (10) the toenail of the large toe came off, and all wounds had good granulation. Sensitivity returned on the fourth day with patient experiencing “hot” burning for about one hour and parasthesia for almost three (3) hours. New skin appeared under the tip of the large toe at twelve (12) days. The hard part at the end of the toe began separating by day thirteen (13). Patient is now under treatment one time daily on both legs. Patient continues to increase in vigor and activity.

Picture “A”
Picture “B”

Studies

Diabetic Extremity Wounds: Overview Case Study 1 Case Study 2 Case Study 3 Case Study 4

Gangrene and Bedsores: Wet Gangrene Dry Gangrene Bedsores 1 Bedsores 2


Dry Gangrene

PATIENT: 56 year old Mexican-American.

DIAGNOSIS: Diabetic Neuropathy-Microangiopathy-Dry gangrene.

HISTORY: Patient had all of his toes remove on his right foot in June 1989. Open wounds remained after surgery. Patient was scheduled for amputation on January 2, 1990.

TREATMENT: Treatment began on December 18, 1989. Worked the anterior tibia to increase circulation to the foot via the tibial planter artery system. Treatments were one time daily for the first two week period. Picture “A” shows the foot on the first day of treatment. Picture “B” was taken on December 28, 1989.

PROGRESS:Surgery was canceled. Open wounds were healed on day twenty-one (21). All open wounds received granulation by the fourth (4) day. Patient is now back at work and doing fine.

Picture “A” Picture “B”

Studies

Diabetic Extremity Wounds: Overview Case Study 1 Case Study 2 Case Study 3 Case Study 4

Gangrene and Bedsores: Wet Gangrene Dry Gangrene Bedsores 1 Bedsores 2


Bedsores 1

PATIENT: 71 year old male.

DIAGNOSIS: Oncology patient. Pain in lower legs, stage three decubitus ulcer on left hip, stage four wound on right hip. Patient unable to roll from left to right side due to extreme disuse atrophy.

HISTORY: Patient has been receiving 440 mg morphine daily and still experiencing acute pain.

TREATMENT: Treatment was originally to retard or maintain the disuse atrophy, increase the range of motion and increase the local circulation.

PROGRESS: Patient received increased analgesia from the first treatment and increasing daily. The first picture was taken on day one (1) of treatment. Picture two and three were taken on day seven (7). Granulation, of the wounds on both side, began on day three. By day sixteen, patient was taken off morphine and began decreasing methadone treatment. Patient began sleeping through the nights on day two (2). He was able to move himself around in his bed by day four (4). The wound on the left hip (picture #1) was totally healed by day eighteen (18). On day 33 the right side still showed minor signs of rumor.

Left Hip – 1st Treatment Right hip – 1st Treatment Left Hip – Day 12

Studies

Diabetic Extremity Wounds: Overview Case Study 1 Case Study 2 Case Study 3 Case Study 4

Gangrene and Bedsores: Wet Gangrene Dry Gangrene Bedsores 1 Bedsores 2


Bedsores 2

PATIENT: 79 year old male residing in a nursing home.

DIAGNOSIS: Decubitus ulcer, stage four (3.5 inches X 2.25 inches) located on the mid thoracic. Acute inflammation.

HISTORY: Patient has been under treatment for this wound three and one-half months. He is in acute pain and an extensive wound management program was performed without results.

TREATMENT: Treatment was begun to increase local circulation and retard the disuse atrophy. Electrode placement was above and below the wound on each side on the spine, twice a day. Picture “A” was taken during the first treatment. Picture “B” at one week.

PROGRESS: This patient has continued to receive analgesia from the first treatment. Granulation was seen on the third day. Reduction of inflammation was seen during the first treatment and has continued. Picture “B” was taken on day ten (10). This shows good granulation and the wound measured 1 ¾ X 2 1/8 inches. At day 32 patient is reported to be doing well and the wound shows only minor rumor.

Picture “A” Picture “B”

 

 


NOTE: FDA contraindications common to all electrotherapy devices:
Implanted Pacemaker, Thrombosis/Phlebitis, Pregnancy, Trans-Cranial Applications,Cancerous Lesions, Varicose Veins, Epilepsy.

For more information on this topic, click here!

Powered by WordPress. Designed by Woo Themes