Verruca Hyperplasia of the Lower Extremity and the Effectiveness of Electrical Stimulation (E-Stim) as an Adjunctive Therapy to Wound Healing – a Case Report

Abstract Body: Purpose & Case Report:   Verrucous Hyperplasia presents as a coalesce of multiple warty lesions which can manifest when a non-healing Diabetic Foot Ulcer (DFU) or amputation stump site is predisposed to traumatic pressure imbalances in the presence of Peripheral Neuropathy (1,2,3). We report of a patient (age: 52, BMI: 32.9 Kg/m2, HbA1c: 6.2, ABI: 1.19) who suffered an ulceration for greater than 24 months who after undergoing E-Stim treatments resolved the lesion in 4 weeks.   Materials and Methods:   Patient received Electrical Simulation (E-Stim) therapy - one hour daily at-home for 4 weeks. E-Stim was adminisered via conductive pads placed at the level of the ankle joint using a bio-electric stimulation technology (BEST) platform (Tennant Biomodulator®, AVAZZIA, Inc).   Results:   4 week post-treatment results showed 92.2% reduction in wound size. Wound measurements were tracked with the ARANZ Medical® Silhouette™ Star Medical Imaging System. There was a 57% improvement in tissue oxygenation (O2SAT) evaluated with hyperspectral imaging provided by the Kent Imaging SnapShotNIR.   Discussion:   E-Stim has been shown to increase angiogenesis and accelerate wound healing by up regulating vascular endothelial growth factor (VEGF) (4). E-Stim allows for immediate VEGF release allowing for the angiogenic perfusion to remain high throughout wound healing in patients with Peripheral Arterial Disease (PAD) (5). E-stem also accelerates wound healing by re establishing cellular electrical current at a wound site to stimulate fibroblasts and cellular migration (6,7). This case report provides results which support the use of this minimally invasive technology as an adjunctive therapy to wound management that can assist in healing of complex non healing wounds.