Randomized control of extracorporeal shock wave therapy versus placebo for chronic decubitus ulceration.

OBJECTIVE

To assess whether extracorporeal shock wave therapy increases the rate of healing in chronic decubitus ulceration.

DESIGN

Double-blind randomized cross-over study.

SETTING

A large, long-stay hospital specializing in the management of people with complex neurological disabilities.

SUBJECTS: The total population of available patients with chronic neurological conditions and chronic decubitus ulceration who met the inclusion criteria.

INTERVENTIONS: Ulcers were randomized into receiving either the extracorporeal shock wave therapy or the placebo for a four-week period, followed by a two-week 'washout' period followed by a four-week period of the cross-over treatment/ placebo.

MAIN MEASURES: Measurement of the area of the ulceration. For each observation the average of three measurements were taken.

RESULTS

Nine ulcers (in eight patients) were included in the study: five on the buttocks/sacrum/trochanter and four on the feet/ankles. All those with static chronic ulcers showed improved healing starting 6-8 weeks after the start of extracorporeal shock wave therapy, whether treated first with the placebo or the therapy.

CONCLUSIONS

Extracorporeal shock wave therapy has a potential part to play in the treatment of chronic skin ulceration.