Effect of polarity on transcutaneous electrical stimulation for the treatment of autogenous graft donor sites in burn patients: randomized blinded clinical study

Author(s)

Camila Silva de Carvalho

• Document type: Master's Dissertation
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC)
• Defense date: 2017-08-30

Examining board members

Elaine Caldeira de Oliveira Guirro; Pedro Soler Coltro; Richard Eloin Liebano; Cacilda da Silva Souza

• Advisor: Elaine Caldeira de Oliveira Guirro

Abstract

The cares with donor areas of skin grafts deserve constant attention, since it triggers discomfort due to pain and movement restriction. There are evidences that electric stimulation may accelerate wound healing and produce pain relief. The objective of this study was to evaluate the effect of electric current polarity on the healing and pain. Therefore, the effects of stimulation on high voltage pulsed current (HVPC) and nervous transcutaneous stimulation (TENS) were compared in the treatment of donor areas of burns victims. Therefore, 48 volunteers of the male sex were randomized between three groups: submitted to high voltage pulsed current stimulation (GHVPC), with 34.2 (± 9.8) years, n=17; submitted to nervous transcutaneous stimulation (GTENS), with 34 (±9.5) years, n=16; and nonsubmitted to stimulation group, or control group (GC), average age of 35 (± 9,5) years, n=15. The therapeutic procedures were applied on the edges of the donor area, at the first postoperative, until complete healing. The evaluated variables were ephitelization time (days), estimated by the unfastening of the primary curative on the wound, evaluation of pain by numerical scale of pain, skin temperature by infrared thermography, scar quality (photo book, Vancouver scale and Image J® software). After data analysis, the Shapiro-Wilk test was applied, and the Wilcoxon test was applied to the before and after intervention. Kruskal-Wallis test followed by Dunn post-hoc was used to compare the groups. In all cases, the significance level of 5% (p<0.05) was used. The findings indicate that the time of release of the Rayon dressing from the donor sites was significantly reduced for GEAV (p <0.033). A reduction of pain relief was significant (p<0.05) for the GEAV and for the GENT, when compared to the GC. Amount the number of solitation for analgesic drugs was decreased for the groups stimulated with significant difference of the GEAV verse GC (p<0.002) and GENT verse GC (p <0.001). Change in cutaneous temperature was not significant between groups. There was no difference significant in score of Vancouver scale and in the number of crusts in the groups. The polarity of the current might have influenced the healing time, however not the pain nor the quality of the donor site. (AU)

• FAPESP's process: 16/04800-0 - Polarity of action on transcutaneous electrical stimulation for the treatment of donor sites for autogenous grafts in burn patients: blind randomized clinical trial
• Grantee: Camila Silva de Carvalho
• Support Opportunities: Scholarships in Brazil - Master