Advances in skin & wound care · 2025
Effect of Electrical Stimulation on Cytokines and Growth Factors Active in the Process of Wound Healing: A Systematic Review of In Vivo Animal Studies and Randomized Clinical Trials.
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Polak Anna, Szołtys-Brzezowska Bogna, Piejko Laura
Аннотация
OBJECTIVE: To systematically review in vivo animal studies and randomized clinical trials (RCTs) analyzing the effects of electrical currents on cytokine and growth factor levels involved in wound healing.
DATA SOURCES: PubMed, EBSCO, Ovid, Elsevier, and online gray literature databases were searched for relevant studies.
STUDY SELECTION: Eligible studies were full-text, English-language in vivo reports or RCTs comparing at least 10 electrically stimulated (ES) wounds with 10 control wounds left untreated or treated with sham ES or nonphysical interventions.
DATA EXTRACTION: Extracted data included ES-induced changes in cytokine and growth factor levels in wounds or blood. Methodologic quality was assessed using the SYRCLE risk-of-bias tool (animal studies) and the PEDro scale (RCTs).
DATA SYNTHESIS: Eight studies (6 in vivo with 349 animals and 2 RCTs with 44 patients with diabetic foot ulcers) published between 2011 and 2021 were analyzed. ES protocols included direct current, low-voltage and high-voltage monophasic, biphasic, and alternating currents applied at sub-sensory to motor intensities. Most in vivo studies reported reduced cytokine levels (IL-1β, IL-6, TNF-α, and IL-10) and increased growth factors (VEGF, FGF-2, EGF, and TGF-β1). RCTs found ES increased VEGF in wounds and blood but did not affect soluble VEGF receptor-2 levels.
CONCLUSIONS: Electrical stimulation favorably modulates cytokine and growth factor expression, supporting faster wound healing. However, due to the limited number and heterogeneity of studies, further high-quality research is required to establish optimal ES parameters.
DATA SOURCES: PubMed, EBSCO, Ovid, Elsevier, and online gray literature databases were searched for relevant studies.
STUDY SELECTION: Eligible studies were full-text, English-language in vivo reports or RCTs comparing at least 10 electrically stimulated (ES) wounds with 10 control wounds left untreated or treated with sham ES or nonphysical interventions.
DATA EXTRACTION: Extracted data included ES-induced changes in cytokine and growth factor levels in wounds or blood. Methodologic quality was assessed using the SYRCLE risk-of-bias tool (animal studies) and the PEDro scale (RCTs).
DATA SYNTHESIS: Eight studies (6 in vivo with 349 animals and 2 RCTs with 44 patients with diabetic foot ulcers) published between 2011 and 2021 were analyzed. ES protocols included direct current, low-voltage and high-voltage monophasic, biphasic, and alternating currents applied at sub-sensory to motor intensities. Most in vivo studies reported reduced cytokine levels (IL-1β, IL-6, TNF-α, and IL-10) and increased growth factors (VEGF, FGF-2, EGF, and TGF-β1). RCTs found ES increased VEGF in wounds and blood but did not affect soluble VEGF receptor-2 levels.
CONCLUSIONS: Electrical stimulation favorably modulates cytokine and growth factor expression, supporting faster wound healing. However, due to the limited number and heterogeneity of studies, further high-quality research is required to establish optimal ES parameters.