A Shock to Wound Healing!

Article by: Sharon Wong

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Introduction

Naturally, the skin generates electricity, known as bioelectricity, when it is wounded. This small electrical current stimulates cells, such as keratinocytes, fibroblasts, and endothelial cells, to migrate and proliferate in an organized manner, facilitating the wound healing.

Electrical Stimulation as an Approach

Recent medical breakthroughs in wound care have introduced electrical stimulation (ES) as a method to enhance bioelectricity and improve the wound healing process. Developed at Chalmers University of Technology, ES works by mimicking the body’s natural electrical currents to promote healing. This controlled stimulation induces ion flow, intracellular polarization, and cytoskeletal changes, which eventually activate signaling pathways to promote wound healing. Additionally, it stimulates nerve cells to generate action potentials and muscle cells for muscle contractions, indirectly promoting wound healing by increasing blood flow.

Mechanism of action of ES

Wound healing works by directing cell migration and alignment of keratinocytes, fibroblasts, and endothelial cells. These cells play crucial roles in re-epithelialization, fibroplasia, and the formation of new blood vessels. Electrical stimulation (ES) guides the cells toward specific alignments, with the direction of the applied ES. The intensity of ES remains below 10 V cm⁻¹. Although increasing the intensity of ES enhances the degree of cell alignment, it may also decrease the cell activity. Caution is necessary, as extremely high intensities may cause cell death. At low intensities (below 1 V/cm), ES can boost proliferation of various cell types, including human dermal fibroblasts and stem cells, by 0.2 to 1.5 fold while maintaining normal cellular functions (Preetam et al., 2024).

ES activates various intracellular signaling pathways when a potential difference is established between the surface electrodes. The electrical field stimulates ion movements, where negative ions attracted to the positive terminal, while positive ions are attracted to the negative terminal. This ion movement generates a current flowing from the anode to the cathode. This ion flow activates ion channels and transporters, leading to intracellular molecular polarization and cytoskeletal changes.

Advantage of ES

ES can enhance perfusion, reduce the risk of infection, improve cellular immunity, and accelerate the healing of cutaneous wounds. In addition to its application on acute wounds, it can also be used in chronic wound healing to reduce the risk of infection. Furthermore, ES can maintain a constant external low-intensity current. This is especially important to compensate for the body’s natural decline of the endogenous healing currents, leading to incomplete wound healing.

Conclusion 

ES is a promising method for both acute and chronic wound healing and can be used as an adjuvant with conventional wound care approaches. However, more research and clinical trials are needed to fully incorporate ES into modern wound care approaches, especially in chronic wound treatment.

Fig. 1 - representation of ES in wound healing

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Citations:

Preetam, S., Ghosh, A., Mishra, R., Pandey, A., Roy, D.S., Rustagi, S. and Malik, S. (2024). Electrical Stimulation: a Novel Therapeutic Strategy to Heal Biological Wounds. RSC Advances, 14(44), pp.32142–32173. doi:https://doi.org/10.1039/d4ra04258a. [Accessed: 21 April 2025]