Healing of chronic arterial and venous leg ulcers with systemic electromagnetic fields

Background. Mitogen-activated autologous peripheral blood mononuclear cells applied locally on the ulcer surface promote healing of chronic arterial and venous leg ulcers. In vitro, extremely low frequency electromagnetic fields (ELF) interact with peripheral C, blood mononuclear cells (PBMC) via Ca++ channels, activating signal transduction cascades, promoting cytokine synthesis, and changing cell proliferation patterns. Methods. ELF frequencies were configured to interact in vitro with the proliferation patterns of PBMC obtained from normal human volunteers. These ELF were then applied peripherally as the sole treatment to 26 patients with 42 chronic leg ulcers of predominantly arterial or venous etiology unresponsive to previous medical and/or surgical treatments in a phase I before-after design. Results. At admission, age of ulcers had a skewed distribution with a median of 639 days. Wound healing or deleterious effects began in all patients during the first 2 weeks after ELF exposure, permitting their previously unresponsive ulcers to function as internal controls. After ELF exposure, 69% of all lesions were cured or healed >50% in a period <4 months. Defective wound healing was observed in lesions associated with important arterial occlusion, uncontrolled arterial hypertension, severe lipodermatosclerosis, non-pitting edema, and obesity (body mass index >30). Lesions worsened in patients with autoimmune diseases. Conclusions. Systemic effects are hypothetically explained by ELF activation of PBMC and their subsequent transportation to the ulcer site via humoral route. This therapy is effective in selected patients with chronic arterial and venous leg ulcers. (C) 2002 IMSS. Published by Elsevier Science Inc.