Publication: Tratamiento con ondas de choque en úlceras cutáneas de largo tiempo de evolución
Loading...
Files
Official URL
Full text at PDC
Publication Date
2017-02-15
Authors
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
Las úlceras cutáneas crónicas (UCC) suponen un problema en la actualidad tanto a nivel social como económico con un exponencial incremento en relación con el envejecimiento poblacional y la comorbilidad que ésta acarrea. El tratamiento de las UC es excesivamente prolongado en el tiempo, requiere un consumo importante de recursos, humanos y económicos, y condiciona una gran merma en la calidad de vida del paciente. Las ondas de choque extracorpóreas (OCE) son ondas sonoras que se han utilizado con éxito en las últimas décadas en gran variedad de procesos clínicos, su uso inicial fue en la nefrolitiasis, posteriormente, en el aparato locomotor, tendinopatias calcificadas, fascitis plantares, pseudoartrosis, etc. Durante estudios realizados en pseudoartrosis se observó como las heridas situadas en el área de aplicación de las OCE cicatrizaban llamativamente de forma más rápida dando lugar este hallazgo accidental a una nueva línea de investigación en estos últimos años. Su exacto modo de acción no es del todo conocido. Por medio de sus mecanismos de inmunomodulación y mecanotransducción parece que las OCE disminuyen los efectos proinflamatorios que cronifican las úlceras cutáneas (UC), aumentan la perfusión de los tejidos isquémicos promoviendo la neoangiogénesis, estimulan los factores de crecimiento y la expresión de células mediadoras en la cicatrización, acelerando la epitelización. También actúan interfiriendo o modulando en la trasmisión del dolor. La evidencia en las publicaciones actuales sugiere que la aplicación de OCE en lesiones de partes blandas es un tratamiento seguro, no invasivo bien tolerado por el paciente, que no requiere anestesia, siendo fácilmente aplicable de forma ambulatoria, eficaz y eficiente...
Chronic wounds are becoming a problem today both socially and economically with an exponential increase in relation to the aging population and comorbidity that this entails. Treatment of Chronic wounds is too long, requires a significant consumption of human and financial resources, and results in a decrease in the quality of life of patients. Extracorporeal shock waves (ESW) are sound waves that have been used successfully in recent decades in a variety of diseases. Initially they have been used for the treatment of nephrolithiasis in the field of medicine especially in the musculoskeletal system, calcified tendinopathies, fasciitis plantar, nonunions, etc. During studies in nonunions it was seen that wounds located in the area of application of the ESW healed remarkably faster, resulting in the accidental new line of research that has increased in recent years. Its exact mode of action is not fully understood, but through mechanisms of immunomodulation and mechanotransduction it seems that ESW reduces the proinflammatory effects that become chronic wounds, increases the perfusion of ischemic tissues promoting neoangiogenesis, and stimulates growth factors and cells mediating expression in accelerating healing epithelialization. It also interferes and modulates with the transmission of pain. The evidence in current literature suggests that the application of extracorporeal shock waves in a soft tissue injury is a safe, non-invasive and well tolerated by the patient, does not require anesthesia, is easily applicable on an outpatient basis, is cost-effective and efficient...
Chronic wounds are becoming a problem today both socially and economically with an exponential increase in relation to the aging population and comorbidity that this entails. Treatment of Chronic wounds is too long, requires a significant consumption of human and financial resources, and results in a decrease in the quality of life of patients. Extracorporeal shock waves (ESW) are sound waves that have been used successfully in recent decades in a variety of diseases. Initially they have been used for the treatment of nephrolithiasis in the field of medicine especially in the musculoskeletal system, calcified tendinopathies, fasciitis plantar, nonunions, etc. During studies in nonunions it was seen that wounds located in the area of application of the ESW healed remarkably faster, resulting in the accidental new line of research that has increased in recent years. Its exact mode of action is not fully understood, but through mechanisms of immunomodulation and mechanotransduction it seems that ESW reduces the proinflammatory effects that become chronic wounds, increases the perfusion of ischemic tissues promoting neoangiogenesis, and stimulates growth factors and cells mediating expression in accelerating healing epithelialization. It also interferes and modulates with the transmission of pain. The evidence in current literature suggests that the application of extracorporeal shock waves in a soft tissue injury is a safe, non-invasive and well tolerated by the patient, does not require anesthesia, is easily applicable on an outpatient basis, is cost-effective and efficient...
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina Física y Rehabilitación (Hidrología Médica), leída el 17-12-2015