Image: An extracorporeal shock wave system treats DFUs (Photo courtesy of Sanuwave).
A novel extracorporeal shock wave system uses pulses of energy in the shock wave spectrum to mechanically stimulate the diabetic foot ulcer (DFU).
The Sanuwave (Suwanee, GA, USA) Dermapace System is based on pulsed acoustic cellular expression (PACE) technology, which utilizes high-energy acoustic pressure waves to produce compressive and tensile stresses on cells and tissue structures in order to elicit a series of biological responses that increase tissue perfusion and arteriogenesis, disrupt biofilm, initiate pro-inflammatory responses, invoke cytokine and chemokine effects, growth factor upregulation, and angiogenesis. The result is a regeneration of tissues such as skin, musculoskeletal, and vascular structures.
The system is intended for the treatment of chronic, full-thickness DFUs with wound areas measuring no larger than 16 cm2, which extend through the epidermis, dermis, tendon, or capsule, but without bone exposure. During treatment, the dermaPACE device pulse applicator is gently applied to the wound surface; an audible “popping” sound is generated until treatment end. In general, only a few treatments lasting just a few minutes are needed; however, treatment time, as well as the overall number of treatments, depends on the wound condition.
“Not all wounds, nor all patients are the same; therefore, each wound is treated on an individual basis, based on the treating physician’s knowledge and the treatment options available. Due to its non-invasive nature, the dermaPACE System does not prevent the use of other treatment options,” said Kevin Richardson II, CEO and chairman of the Board of Sanuwave. “The dermaPACE system offers the ability to manage the DFUs chronicity, and is a powerful tool in the clinician’s arsenal to achieve wound closure.”
Diabetes patients often suffer from nerve and circulation problems in the feet, which reduce their perception of pain. The nerve pathways that ensure that weight is automatically transferred from one foot to the other during prolonged standing are disrupted, and as a result, diabetics do not notice that their toes, heels, or the balls of their feet are too heavily loaded. The foot receives no relief, and due to the neuropathy, pressure sores, DFUs, and infections may go unnoticed. Serious cases may even lead to amputation.