NON-MEDICATION TECHNIQUES FOR WOUND HEALING: CLINICAL CONSIDERATIONS

Objective: Several non-medication techniques have been proposed for the treatment of chronic wounds. Electric and magnetic fields, electromagnetic fields [EMFs], ultrasound [US], and photostimulation are some of these techniques with promising potentials. However, the clinical efficacy of these techniques for different chronic wounds is still not fully understood and standard guidelines on the allowed doses and possible side-effects should be determined. This paper aims to comprehensively review the therapeutic efficacies and clinical considerations of the main non-drug techniques for chronic wounds. Methods: The databases of PubMed [1985-2016], EMBASE [1985-2016], Web of Sciences [1985-2016], and Google Scholar [1980-2016] were searched using the set terms of "non-medication" OR "non-drug treatment" AND "wound treatment". The obtained results were screened for the title and abstract by two authors and the relevant papers were reviewed for further details. Results: Pulsed EMFs [PEMFs], non-contact low frequency US or MIST therapy, and Low Level Laser Therapy [LLLT] are the main non-drug techniques with promising effective outcomes for different wounds. PEMFs and MIST therapy have been used in some clinical studies with promising outcomes. In addition different lasers particularly HeNe lasers have shown therapeutic effect of superficial wounds. Despite of rigorous evidence on the therapeutic efficiency of these techniques, the main limit on developing approved clinical protocols of these techniques for wound treatment is the lack of definite dose-response on the clinical trials of these techniques. Conclusion: The available data showed the therapeutic efficacy of PEMFs, MIST, and LLLT techniques for chronic wounds. Further in vitro and in vivo preclinical and clinical trials are needed to understand the mechanism of actions of these techniques for developing clinical protocols and guidelines of these techniques for treatment of different wounds. Key words: Non-medication, Wound, Clinical Considerations, Treatment