Treatment of Chronic Wounds and Ulcers with Focused and Defocused Shock Waves

Abstract

Shock waves are mechanical and repetitive stimuli with high energy that are similar to acoustic waves, capable of stimulating the biological healing of both acute and chronic pathological tissues. The effects can be achieved with significantly lower energy treatment protocols that are better tolerated and free of significant side effects, making them applicable in the treatment of ulcers. The physical or biological reactions that occur are of three types. The first reaction has direct effects on the interface, meaning that when the wave front passes between two media with a significant density difference, a high amount of energy is released. The second reaction occurs through the formation of vapor bubbles in the liquids crossed by shock waves. Inside the bubbles, there is a negative pressure that tends to induce collapse when new shock waves reach them. The third reaction is a physical-biological reaction, specifically mechanotransduction, where shock waves passing through the tissue cause high-pressure gradients of approximately 160 megapascals per square millimeter. The treatment is clinically effective, non-invasive, and well-tolerated by patients, and it does not require anesthesia. It is cost-effective and easily applicable in an outpatient setting.