Pulsed Electromagnetic Energy In Management Of Chronic Wounds: A Systematic Review

Objectives: To assess the evidence regarding effectiveness of pulsed electromagnetic energy (PEME) on the healing of chronic wounds; to explore whether there is an optimum treatment regime with regards to total current, pulse amplitude, pulse duration, and duration and frequency of treatments.Methods: A computerised literature search of the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE and PubMed was performed. Only randomised clinical trials (RCT), controlled trials, and clinical trials that studied a population aged 18 years of age or more and investigated the effects of a type of PEME in the management of a chronic wound were included. The methodological quality of the included trials was assessed qualitatively using a set of formal criteria as recommended by van Tulder et al.Results: Eleven studies (n=360) out of 40 were included of which six were of high methodological quality. Methodological scores ranged from one to nine (maximum 11) with a mean score of 5.5 (SD=1.73). For venous ulcers, there is strong evidence that PEME is more effective than sham PEME. For pressure and plantar ulcers, there is moderate evidence that PEME, in combination with conventional wound care is better than conventional wound care alone. The heterogeneity in duration, frequency, voltage and magnetic field made it difficult to make detailed comparisons or specific recommendations regarding its application.Discussion: Further research should focus on controlling baseline recruitment parameters within an RCT, studying vital outcomes, and exploring combinations of parameters regarding optimum usage of PEME.