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Is the use of HVPC or Microcurrent indicated for healing diabetic foot ulcers in individuals with decreased sensation of the limb?

We have a patient with a chronic unhealing ulcer on her heal that we are considering using either HVPC or microcurrent treatment for. We are worried about applying a modality to fragile skin with decreased sensation. The ulcer has been unhealed for over a year and the patient has recurrent issues with infection... Any input is appreciated as we are rural-remote and have limited experience with wound healing.

Caitlin DuBiel

9 months ago

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Prof Gad Alon
Prof Gad Alon

I ended up discussing Caitlin case (question) outside the forum because it appeared much too complicated to respond via email. Whether my suggestions were helpful or not she is the one to answer.

evahadjidemetri227
evahadjidemetri227

Hi Caitlin, I am late but I only joined this forum. I use FSM- Frequency Specific Microcurrent. It is safe and very gentle. Works amazing and the electrodes are placed above and below the ulcers, so there is no worries about infection. I also recommend to patients accel heal . You can go on their website www.accelheal.com . It works like magic. The ulcers are healed in 12 days. Good luck. Physiotherapist and FSM Practitioner , London

Last updated 6 months ago

patrick.debock99
patrick.debock99

Dear Caitlin,

Theoretically monophasic microcurrent indeed can cause skin burns. However, I never observed this. I can't count the times I used it and many patients had conditions (including diabetes) leaving their skin in bad shape. If still in doubt, the solution is simple, use the biphasic microcurrent pulse. Many manufacturers of microcurrent machines have these biphasic pulses as well, some even only have these. I worked with a wide variety of microcurrent devices and observed equally good results with the biphasic pulses.

Patrick De Bock

Prof Luther Kloth
Prof Luther Kloth

Dear Caitlin: If I were to use only electrical stimulation to treat the heal ulcer on your patient, I would use high voltage pulsed current because my guess is that your patient has diabetes and the heal wound has resulted from diabetic neuropathy. Thus the risk of creating as polar or chemical burn effect will be less likely with HVPC than with microcurrent D.C. However, my emphasis on treating a diabetic neuropathic plantar ulcer is to offload plantar pressure during ambulation with a specially designed "shoe" you can find by Goggling "offloading shoes for diabetic foot ulcers" or even better Google "total contact cast" for treating diabetic plantar ulcers. Let me know if I can be of further assistance, Luther Kloth

patrick.debock99
patrick.debock99

Hi Caitlin,

I had very good results with microcurrent and diabetic foot ulcers. Though there's literature with positive outcome about it I never tried with HVPC. So, back to microcurrent. If you have a special sterile wound electrode, you can put it on the ulcer and connect to negative. The positive electrode can be put anywhere above, below, left or right from the negative one. If you don't have a wound electrode, take 2 self-adhesive electrodes and put them above/below the ulcer. Discussing the parameter settings would take us too long, I'm only giving you what I used on several occasions and worked very well. Monophasic pulse/ frequency: 0.5 Hz/ pulsewidth: 250 ms/ no burst mode/ modulation on (preferably frequency + pulsewidth + intensity)/ treatment time: 60 minutes/ intensity 600 µA. Treatment interval was every second day or at least twice a week. A lot of wounds healed completely. Of course the success rate depended on the condition the patient was in.

Patrick De Bock, PT, Physiotherapy school, University of Antwerp, Belgium

Prof Gad Alon
Prof Gad Alon

The APTA provide a PowerPoint handouts but you can only access them if you are a member or attend the conference.

Unfortunately I can not help you via the forum. Please send me an email directly to my University email galon@som.umaryland.edu so we can communicate in private and I will try to help.

Dr. Alon

caitlin.dubiel199
caitlin.dubiel199

Hello Dr. Alon, I am a Canadian clinician so I don't think I have access to APTA meetings. Will your discussion be recorded and made available anywhere?

Prof Gad Alon
Prof Gad Alon

Dear Caitlin, I will discuss the different treatment options at the APTA CSM meeting on February 17. Will you attend?

Dr. Alon

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