Complex Diabetic Ulcers with Arterial Compromise Healed With Pulsed Radiofrequency Energy Therapy

Objective: 

To evaluate the effect of pulsed radiofrequency energy (PRFE) on wound closure for three patients with lower extremity ulcers associated with severe peripheral arterial disease (PAD).

Method:

This retrospective review was performed on three veterans with a mean age of 66 years. All patients had severe non-operable PAD; two with poorly controlled type II diabetes. All patients were treated with PRFE* at home for 30 minutes twice daily. Therapy duration varied.

Results:

Wound closure occurred in all 3 cases with time to heal occurring at 2 months and 5-6 months for non-diabetic and diabetic ulcers respectively. 

Discussion:     

PAD is most commonly associated with hypertension, diabetes and dyslipidemia. Complex processes trigger local inflammation which plays a key role in the development of atheroma, vascoconstriction and endovascular dysfunction eventually resulting in peripheral ischemia, pain and poor wound healing. 

Wound healing associated with PRFE therapy is thought to be related to expeditious resolution of chronic inflammation progressing to fibroplasa and angiogenesis. In vitro studies demonstrate the ability of PRFE to enhance gene expression for crucial inflammatory mediators, including growth factors, cytokines, matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs).

Conclusion:

The ability of  PRFE to modualte the wound inflammatory environment may have conrtibuted to the observed imporvements in healing ulcers associtated with severe arterial compromise.  This home based therapy may lead to imporved patient satisfaction.