Accelerated Healing of Sacral Wound in a Rehabilitative Paraplegic Patient with Electrical Microcurrent Therapy: A Case Report
by Gil J. Cerros1*, William R. Marañón2, Adolfo R. Rodriguez3
1Clinical and Translational Research, The George Washington University School of Medicine and Health Sciences. Texas NeuroRehabilitation Center. Bioenergetic Treatment Center for Wound Care, USA
2Medical Doctor MD, University of California San Diego School of Medicine, Summerlin Hospital Medical Center Chief of Surgery, Mountainview Hospital, Bioenergetic Treatment Center for Wound Care, USA
3Health Science. Provident University, Bioenergetic Treatment Center for Wound Care, USA
*Corresponding author: Gil J. Cerros, Clinical and Translational Research, The George Washington University School of Medicine and Health Sciences. Texas NeuroRehabilitation Center. Bioenergetic Treatment Center for Wound Care, USA
Received Date: 24 October 2023
Accepted Date: 28 October 2023
Published Date: 31 October 2023
Citation: Cerros GJ, Marañón WR, Rodriguez AR (2023) Accelerated Healing of Sacral Wound in a Rehabilitative Paraplegic Patient with Electrical Microcurrent Therapy: A Case Report. Ann Case Report 8: 1496. https://doi.org/10.29011/2574-7754.101496
Introduction: This case report demonstrates that electrical microcurrent therapy (EMT) is both efficient and effective in enhancing wound healing both in simple and complex wounds. EMT uses low-intensity currents placed across a wound. This treatment leads to a faster cure and healing of the wound. And, return to a standard, painless state. Wound care in a rehabilitation environment is a costly and challenging problem. This case report translates into improved patient care and significant cost savings. Patient Concerns: This report is of a 54-year-old paraplegic male. The patient had a stage 3 decubitus ulcer. This type of wound is very common in spinal cord injury patients (SCI). The patient had a stable, non-healing wound that developed four years after his spinal cord injury. In a significant percentage of patients with this type of injury, there is minimal to no improvement with standard-of-care therapy. Paraplegic spinal cord injury patients are at high risk for pressure injury wounds. There is a significant risk for infection, morbidity, mortality, and increased healthcare costs. Diagnosis case report: Sacral Stage 3 Decubitus Pressure Ulcer. Interventions case report: The patient underwent a total of 10 electrical microcurrent treatments over the course of 5 weeks. Each treatment session lasted approximately 30 minutes and was conducted twice a week. Outcomes: With EMT, this wound was healed with 10 treatments over a 5-week time period. This is half the time needed with the current standard-of-care if it is to heal at all. Conclusion: Improved methods such as this are slowly being developed. Advanced wound therapies, such as EMT, are typically introduced after standard-of-care approaches fails. The time has come to consider this type of treatment early on in caring for complex wounds.
Keywords: EMT-Electrical Microcurrent Therapy; tSCITraumatic Spinal Cord Injury; PU-Pressure Ulcer; SOC-Standard of Care
EMT involves the application of a low-level electrical current to stimulate tissue healing and regeneration. This therapy has been used for various conditions, including pain management, tissue healing, and muscle stimulation. In the context of complex wound healing, EMT is effective in promoting tissue regeneration and reducing inflammation. EMT stimulates the production of adenosine triphosphate (ATP), which is the energy source for cellular metabolism. This increased cellular energy production can stimulate the healing process by promoting cell proliferation and tissue regeneration. Additionally, EMT can improve blood flow to the affected area, which can aid in the delivery of nutrients and oxygen to the wound. The 2022 population size in the United States was estimated to be about 334 million. The most recent estimates of the annual incidence of tSCI are approximately 54 cases per one million people in the United States, which equals about 18,000 new tSCI cases annually [1,2]. Annually, 12,500 people survive spinal cord injuries (SCI). Most of these SCIs are caused by car accidents (38%), followed by falls (30%), violence (14%), sports and other recreational activities (9%), medical errors (5%), and various other factors (4%), according to the National Spinal Cord Injury Statistical Center . SCI patients have a high risk of acquiring pressure ulcers because of motor and sensory impairments, immobility, changes in skin composition, and prolonged length of hospital stays. Pressure wounds are a substantially expensive and chronic problem of SCI. Roughly 30–40% of SCI patients develop pressure ulcers through acute and rehabilitation hospitalizations . Wound care in inpatient settings is costly and complicated when treated only with wound SOC. A two-center retrospective study by Whitcomb  established a 45.5% shorter healing of wounds using a microcurrent-generating wound device (MCD) compared to a wound SOC during the rehabilitation phase. This two-center study showed that the wounds in the SOC group closed on average at 36.25 days (SD = 28.89), while the MCD group closed significantly faster at 19.78 days (SD = 14.45), p = 0.036. The daily volume reduction rate was – 3.83% for SOC vs. – 9.82% per day (p = 0.013) for the MCD group. The SOC group had 50% of its wounds close monotonically vs. 83.3% in the MCD group (p = 0.018). This improves patient care and potentially significantly lower healthcare costs [3,4].
The patient is a 54-year-old male who has been a paraplegic for 4 years following a traumatic spinal cord injury. He had no history of sacral pressure ulcers; however, his current wound had been present for 3 months. The wound length, width, and depth measured 9.00 cm x 6.0 cm x 1.1 cm and was classified as a stage three pressure ulcer, as noted in Figure 1. The pressure ulcer had progressed beyond the superficial layers of the skin and into the underlying tissue. At this stage, the wound appears as a deep crater with a depth of up to several millimeters. The wound bed contains slough; the edges are irregular, and odor is present. The patient was referred to our wound care center to manage his sacral wound. After a thorough evaluation, it was determined that electrical microcurrent treatment would be an appropriate treatment modality for this patient’s wound. The patient’s medical history was unremarkable; no premorbid conditions were reported, and the only complications were related to his current neurogenic bowel and bladder. The patient current level of function was limited to minimal assistance with transfers mobility and supervision with all activities of daily living. The patient underwent a total of 10 electrical microcurrent treatments over the course of 5 weeks. Each treatment session lasted approximately 30 minutes and was conducted twice a week. After completing the treatment plan, the patient’s sacral wound had completely healed. The patient reported a significant decrease in odor and improved overall quality of life. The patient reported no adverse events throughout the treatments. The patient reported significant improvement in his quality of life and his activities of daily living secondary to the accelerated healing of his sacral wound. The patient has provided informed consent for the publication of the case. Follow-up measurements and treatment progress are appreciated chronologically in Figures 1-5.
Figure 1: Represents the initial wound picture presentation on 03 November 2022, measuring 9x6 cm.
Figure 2: Represents the follow-up EMT treatment day 12 on 15 November 2022, measuring 7x5 cm.