Mechanical Modalities in Management of Wound 

1. Ultrasound

• Ultrasound stimulates cell activity, collagen secretion, skin repair, accelerates the process of inflammation, accelerating wound contraction, and strengthens scar tissue (Fig. 1).

• The procedure for treatment is to cover the wound with a sheet of hydrogel or an application of amorphous hydrogel. 

• Ultrasound is then delivered with hand-held applicators.

  

  Fig. 1: Ultrasound therapy in wound healing
  

  
  

2. Electrical Stimulation

• The use of electrical stimulation to treat chronic and acute pain (Fig. 2).

• Electrical stimulation is recommended to eliminate the bacterial load, promote granulation, decrease inflammation, reduce edema, reduce wound-related pain.

  

  Fig. 2:Electrical stimulation in wound healing
  

  
  

3. Thermal and Nonthermal Diathermy

• Pulsed short-wave diathermy (PSWD), continuous short-wave diathermy (CSWD), and nonthermal pulsed radiofrequency stimulation (PRFS) are used to treat chronic open wounds.

• PSWD heats superficial and deep tissues.

• CSWD heats deep muscle and joint tissues.

• PRFS is nonthermal and influences tissue at the cellular level.

• Patients with arterial insufficiency are contraindicated for PSWD and CSWD because their tissues are not able to dissipate heat enough to avoid burns.

• Diathermy help to increased fibroblast proliferation, collagen formation, tissue perfusion, and metabolic rate.

4. Ultraviolet Radiation

• Ultraviolet Radiation energy is a form of radiation between x-ray and visible light on the electromagnetic spectrum (Fig. 3).

• UV has cutaneous and bacterial effects that include:

• Increased blood flow

• Increased granulation tissue formation

• Destruction of bacteria

• Stimulation of vitamin D formation

• Thickening of stratum corneum

• UV radiations also act on antibiotics resistant bacteria.

  

  Fig. 3: UV rays in wound healing
  

  
  

5. Hyperbaric Oxygen Therapy

• HBOT delivers 100% oxygen at a pressure greater than atmospheric pressure.

• The HBOT treatment;

•  increases the amount of oxygen available for cell metabolism,

• improve the oxygen delivery to hypoxic tissue.

• The risk of HBOT treatment is Oxygen toxicity.

6. Cold Laser Therapy

• Also called low-level infrared laser or monochromatic infrared photo energy (MIRE).

• Cold laser therapy has been promoted for augmenting wound healing and reversing the symptoms of peripheral neuropathy in patients with diabetes.

• Effects of cold laser therapy:

• Increase circulation

• Reduce pain

• Increase the release of nitric oxide.