Extracorporeal Shock Wave Therapy in Chronic Wound Care

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Abstract
Chronic wounds are wounds, which failed healing and timely reparative process to produce anatomic and functional integrity over a period of 3 months. New physical therapy for chronic wounds is extracorporeal shock wave therapy (ESWT). ESWT generators can be focused, defocused, and radial. ESWT is non-invasiveness, low-associated complication rates, efficacy for indications refractory to other standards of practice, and cost-effectiveness. ESWT determines mechanotransduction that is possible as most of the cells of the body, thank to surface receptors and other transmission signals. In the specific field of ESWT, different biochemical substances are able to influence the processes of different cell lineages, besides to induce the formation of new small blood vessels. So, ESWT enhanced cell proliferation at the local wound tissue level, stimulated extracellular matrix metabolism, decreased apoptosis, and downregulated oxygen-mediated burst of leukocytes, probably stimulating homing and differentiation of stem cells with high tissue regenerating potential. From numerous experimental and clinical data, it is possible to conclude that ESWT would improve not only the wounds healing process but also the regeneration events.

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