Case Studies supporting PEMF benefits for Wound Healing
Evaluation of the effects of Extremely Low Frequency (ELF) Pulsed Electromagnetic Fields (PEMF) on survival of the bacterium Staphylococcus aureus
Background: This study investigated the effects of extremely low frequency (ELF) pulsed electromagnetic field (PEMF) radiation on the growth of bacterium Staphylococcus aureus (ATCC 25923) that plays a versatile role in infecting wounded tissues. The viability of these bacteria (number of live cells as colony-forming units (CFUs)) was measured before and after the ELF PEMF exposures to quantify their survival rate.
Methods: S. aureus cultures were first cultivated in an agar medium, and then picked and suspended in Columbia broth medium. Optical density reading for the suspended bacteria was measured at 600 nm and adjusted to a specific value of 0.1 ± .005A prior to experimentation and placement of bacteria into 2.5 mL centrifuge tubes. Sham-exposed tubes filled with bacteria were kept under the same experimental conditions and used as controls. The constructed exposure system, emitting uniform time varying magnetic fields (frequency of 2-500 Hz, and magnetic induction of 0.5-2.5 mT), was employed to irradiate S. aureus bacteria for 90 min. To determine the CFU per ml of the exposed bacteria, five serial dilutions were performed. A volume of 100 μl from the last tube was suspended onto agar plates by spread plating. After incubation, the colonies formed on the plates were visually counted.
Results: All irradiated S. aureus bacteria showed decrease in their growth rate compared to control samples. The results demonstrated that ELF PEMF exposures at 150-500 Hz are more effective than exposures at 3-100 Hz in reducing the viability of S. aureus in broth. The lowest CFU value was achieved with the exposure at 300 Hz and 1.5 mT. The decrease of at least 20% in CFU value was obtained for frequencies above 200 Hz and all five studied magnetic flux densities (0.5 mT. 1.0 mT, 1.5 mT, 2.0 mT, and 2.5 mT).
Conclusions: In summary, the growth rate of the irradiated S. aureus bacteria is affected by radiation of particular parameters, thus revealing resonant effects induced by the applied radiation. The decreased CFU values in all irradiated samples compared to control samples (non-exposed) were observed. Findings provide important insight towards selecting the optimal parameters of ELF PEMF for possible treatment of infected tissue and thus, wound healing promotion.
Evidence-Based Use of Pulsed Electromagnetic Field Therapy in Clinical Plastic Surgery
Background: The initial development of pulsed electromagnetic field (PEMF) therapy and its evolution over the last century for use in clinical surgery has been slow, primarily because of lack of scientifically-derived, evidence- based knowledge of the mechanism of action.
Objective: Our objective was to review the major scientific breakthroughs and current understanding of the mechanism of action of PEMF therapy, providing clinicians with a sound basis for optimal use.
Methods: A literature review was conducted, including mechanism of action and biologic and clinical studies of PEMF. Using case illustrations, a holistic exposition on the clinical use of PEMF in plastic surgery was performed.
Results: PEMF therapy has been used successfully in the management of postsurgical pain and edema, the treatment of chronic wounds, and in facilitating vasodilatation and angiogenesis. Using scientific support, the authors present the currently accepted mechanism of action of PEMF therapy.
Conclusions: This review shows that plastic surgeons have at hand a powerful tool with no known side effects for the adjunctive, noninvasive, nonpharmacologic management of postoperative pain and edema. Given the recent rapid advances in development of portable and economical PEMF devices, what has been of most significance to the plastic surgeon is the laboratory and clinical confirmation of decreased pain and swelling following injury or surgery.
Extremely low frequency electromagnetic field and wound healing: implication of cytokines as biological mediators
Wound healing is a highly coordinated and complex process involving various cell types, chemical mediators and the surrounding extracellular matrix, resulting in a tightly orchestrated re-establishment of tissue integrity by specific cytokines. It consists of various dynamic processes including a series of overlapping phases: inflammation, proliferation, re-epithelialization and remodeling. One of the underlying mechanisms responsible for the disturbances in wound healing is an out-of-control inflammatory response that can cause pathological consequences, such as hypertrophic scars, keloids or chronic wounds and ulcers. Recently, several reports have evaluated the effects of extremely low frequency electromagnetic fields (EMFs) on tissue repair. In particular, the data analysis supports an anti-inflammatory effect of EMFs by the modulation of cytokine profiles that drive the transition from a chronic pro-inflammatory state to an anti-inflammatory state of the healing process. In this review, we focus on the effect of EMFs on skin wound healing showing emerging details of the anti-inflammatory effects of EMFs, with a view to cytokines as candidate biomarkers. Molecular clarification of the mechanisms involved in the modulation of inflammatory factors following exposure to EMFs will provide a better understanding of the cellular responses induced by EMFs and a potential, additional treatment in non-responding, chronic wounds.
Low-frequency pulsed electromagnetic fields significantly improve time of closure and proliferation of human tendon fibroblasts
Background: The promotion of the healing process following musculoskeletal injuries comprises growth factor signalling, migration, proliferation and apoptosis of cells. If these processes could be modulated, the healing of tendon tissue may be markedly enhanced. Here, we report the use of the Somagen™ device, which is certified for medical use according to European laws. It generates low-frequency pulsed electromagnetic fields that trigger effects of a nature that are yet to be determined.
Methods: : A 1.5-cm wide, linear scrape was introduced into patellar tendon fibroblast cultures (N = 5 donors). Treatment was carried out every second day. The regimen was applied three times in total with 30 minutes comprising pulsed electromagnetic field packages with two fundamental frequencies (10 minutes of 33 Hz, 20 minutes of 7.8 Hz). Control cells remained untreated. All samples were analyzed for gap closure time, proliferation and apoptosis one week after induction of the scrape wound.
Results: The mean time for bridging the gap in the nontreated cells was 5.05 ± 0.33 days, and in treated cells, it took 3.35 ± 0.38 days (P <0.001). For cell cultures with scrape wounds, a mean value for BrdU incorporation of OD = 0.70 ± 0.16 was found. Whereas low-frequency pulsed electromagnetic fields treated samples showed OD = 1.58 ± 0.24 (P <0.001). However, the percentage of apoptotic cells did not differ between the two groups.
Conclusions: Our data demonstrate that low-frequency pulsed electromagnetic fields emitted by the Somagen™ device influences the in vitro wound healing of patellar tendon fibroblasts and, therefore, possibly increases wound healing potential.
Pulsed Electromagnetic Fields (PEMF) Promote Collagen Fibre Deposition Through Myofi bro blast Proliferation in Early Diabetic Wound
Objective: To evaluate the effect of PEMF on collagen fibre deposition and myofibroblast proliferation in diabetic wound healing.
Design: randomized control trial; placebo control.
Participants: Forty young male streptozotocin-induced diabetic Sprague- Dawley rats were used, and a 2cm x 2cm wound was induced at the back. They were randomly assigned to the PEMF (nZ20) or control group (nZ20).
Interventions: For the PEMF group, the wounds were exposed to 60min of PEMF daily for 2 weeks at 5mT, 25Hz and with a 40ms pulse width. The control group did not expose to PEMF.
Main Outcome Measure(s): Wound tissues harvested on post-wounding day 7, 10 and 14 were fixed, processed and sectioned. Type I collagen was quantified using picro-srius red polarization method and imaging software. Myofibroblast population was examined by fluorescent immunohistochemistry against a-smooth muscle actin (a-SMA), and the a-SMA immunoreactivity was scored using semi-quantitative ratings.
Results: Significantly greater abundance of type I collagen fibre was found in the PEMF group than in control only on day 7 (PZ.013). Myofibroblasts population on day 7 and day 10 was also significantly greater in the PEMF group than in control (day 7: PZ.042; day 10: PZ.024). A strong and positive correlation was found between collagen fibre deposition and myofibroblast population on day 7 (rZ.729, PZ.007).
Conclusions: PEMF increases collagen fibre deposition and myofibroblast population in the early phase of diabetic wound healing. The increase in collagen fibre deposition in early diabetic wound could be due to enhancement of myofibroblast proliferation.
Case Study Reference Source:
1. Evaluation of the effects of Extremely Low Frequency (ELF) Pulsed Electromagnetic Fields (PEMF) on survival of the bacterium Staphylococcus aureus
(Authors: Istiaque Ahmed, Taghrid Istivan, Irena Cosic and Elena Pirogova)
2. Evidence-Based Use of Pulsed Electromagnetic Field Therapy in Clinical Plastic Surgery
(Authors: "Berish Strauch, MD", "Charles Herman, MD", "Richard Dabb, MD", "Louis J. Ignarro, PhD" and "Arthur A. Pilla, PhD")
3. Extremely low frequency electromagnetic field and wound healing: implication of cytokines as biological mediators
(Authors: Mirko Pesce, Antonia Patruno, Lorenza Speranza, Marcella Reale)
4. Low-frequency pulsed electromagnetic fields significantly improve time of closure and proliferation of human tendon fibroblasts
(Authors: Claudine Seeliger, Karsten Falldorf, Jens Sachtleben and Martijn van Griensven)
5. Pulsed Electromagnetic Fields (PEMF) Promote Collagen Fibre Deposition Through Myofi bro blast Proliferation in Early Diabetic Wound
(Authors: Ming-Chun Choi (Department of Rehabilitation Sciences, The Hong Kong Polytechnic University), Kwok-Kuen Cheung, Xiaohui Li, Gladys Lai-Ying Cheing)