Transcutaneous Electrical Nerve Simulator Burn Wound

In this case study, the authors (John L. Gwin, MD, FACS, CWSP; Julia Vervantes Aguilar, MSN, APRN, FNP-BC) discuss a case of a patient with diabetic neuropathy without sensation, for whom therapy was done using such a device.¹ This poster abstract, “Burn Wound After Use of a Transcutaneous Electrical Nerve Simulator,” was presented at the Symposium on Advanced Wound Care (SAWC) Spring | Wound Healing Society.

A 62-year-old male presented to an outpatient wound center with a burn wound of his left foot.¹ The authors note that the patient was affected by type 2 diabetes and associated neuropathy. The treatment plan for his sensory neuropathy involved therapy with an immersion TENS unit. After the second session of the therapy, the patient noted redness and blistering of the right foot. The patient was then seen at the author’s clinic one week after the burn injury.

The circumferential injury is described to have blisters, erythema, and edema. The patient reported loss of sensation and was tested using the Semme-Weinstein method. The authors then proceeded to debride the wound of nonviable tissue, which was performed and treated using silver sulfadiazine cream and sterile gauze daily.

According to the authors, the wound healed in approximately six weeks without need for tissue grafting.

This case report demonstrates the potential complications of using TENS therapy in patients with diabetic neuropathy, especially using an immersion TENS unit. The authors postulate that the burn wound was a result of the conductive solution, which was heated to a temperature capable of causing a burn wound, but the patient was unaware of the heat due to the neuropathy. The authors use this case report as an affirmation that TENS therapy is contraindicated for patients with sensory neuropathy and TENS therapy should always be used with care. --Jaclyn Gaydos, Senior Managing Editor

Poster Reference:

1. Gwin JL, Aguilar JV. Burn Wound after use of a Transcutaneous Electrical Nerve Simulator. Poster presented at: Symposium on Advanced Wound Care Spring; April 6-10, 2022.