The Use of Noninvasive Pulsed Acoustic Cellular Expression System to Promote Angiogenesis in Chronic Wounds

Introduction: Chronic lower extremity wounds present significant challenges with regard to effective wound management. Ischemia, microcirculatory dysfunction, and PVD cause limitations in blood flow that can delay the healing process.

An innovative noninvasive pulsed acoustic cellular expression (PACE) system delivers high-energy acoustic pressure waves using the electrohydraulic shockwave principle to produce compressive and tensile stresses on cells and tissue to promote angiogenic and positive inflammatory responses.

There are various methods for measuring skin perfusion and wound tissue oxygenation. One such device is a novel near-infrared camera system (NIRC) that captures the percentage of oxygenated hemoglobin in and around the wound.

Background: This is a prospective, single site, single-arm pilot case series. The goal of this study aims to determine the effects of weekly PACE therapy on localized skin perfusion and wound healing as measured with a near-infrared imaging camera.

Methods: Ten patients with lower extremity wounds were treated with the PACE system according to wound size. A baseline NIRC image was taken prior to starting the PACE therapy. Subsequent weekly NIRC images of the wounds were taken prior to the PACE treatment. Changes in amounts of oxygenated hemoglobin in the wound, as well as wound measurements, were tracked weekly.

Results: In the 10 patients receiving PACE therapy, all displayed an increase in oxygenated hemoglobin in the wound base and peri-wound area on the NIRC images. All 10 patients also developed a healthy granulated tissue bed utilizing the PACE system. Weekly wound measurements were also improved in this patient cohort.

Conclusion: In the author’s opinion, PACE therapy offers an improved noninvasive standard of care that may initiate the healing cascade and shorten wound healing by improving microcirculation and oxygenated hemoglobin, subsequently allowing for the regeneration of tissue such as granulation tissue and skin in chronic wounds.