Focused Piezo Shockwaves to treat Wounds of the diabetic foot syndrom
Die Extracorporeal shockwave therapy (ESWT) for wound management is a non-invasive procedure to stimulate wound healing. A shockwave is a strong, expansive, acoustic pressure wave with an extremely short rise time of just a few nanoseconds, which is followed after a few microseconds by a brief moment of negative pressure, after which pressure returns to normal again. The focused shockwaves used in ESWT reach their highest point of pressure precisely in the target tissue.
For a long time the biological mode of action of shockwaves and how they improved wound healing was not understood; recently, the effects have been described very precisely. Research results have been confirmed by clinical experiences reporting significant improvements in wound healing.
In recent years, numerous scientific studies and publications, some of which also used focused piezo shockwaves, have described the mechanism of action of ESWT in stimulating wound healing. In principle, ESWT is a strong, targeted, mechanical stimulus which promotes biological self-healing processes. On closer inspection, wound healing is the result of a number of complex shockwave effects. Mechanical stimuli infl uence many cellular functions in living tissue, including cell growth, cell differentiation, cell migration, protein synthesis, physiological apoptosis and tissue necrosis. Extracorporeal shockwaves are mechanical stressors capable of inducing biochemical changes in living tissue, which on a molecular level ultimately affect the gene expression of cells, thereby eliciting certain tissue reactions when selectively applied. This process is referred to as mechanotransduction.
Mechanisms of action and effects of ESWT described in the literature:
- induced release of growth factors such as TGF-Ð1, VEGF
- stimulation of fi broblast proliferation
- stimulation of mesenchymal stem cell migration
- antibacterial effect
- stimulation of local blood fl ow and suppression of pro-infl ammatory processes
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