Extracorporeal shock waves, a new non-surgical method to treat severe burns.

Abstract

Extracorporeal shock wave treatment (ESWT) increases perfusion in ischaemic tissues, stimulates growth factors, decreases inflammation and accelerates wound healing. It is a safe technique classically used in urology and orthopaedic surgery with success, but there is still limited literature regarding its use in the management of burns. The aim of this study is to analyse the effect of ESWT on deep partial/full thickness burns in patients attended at our emergency burn unit. We performed two ESWT sessions in 15 patients with <5% TBSA (total body surface area) deep partial/full thickness burns, on the third and fifth day after injury; prior to each session, we used laser Doppler imaging (LDI). Of all treated burns, 80% healed uneventfully prior to 3 weeks; as many as 15% required surgical debridement and grafting and 5% developed hypertrophic scarring. After one ESW session, burns had a significant increase in perfusion, objectivated by the LDI images. Extracorporeal shock wave therapy emerges as a new non-invasive, feasible, safe and cost-effective method in deep partial/full thickness burns. It may decrease the need of surgery and therefore the morbidity of the patient. There is a strong need for more studies to establish the optimal timing and dosage of treatment.