WIRELESS MICROCURRENT STIMULATION PIONEERING PHILIPPINE EXPERIENCE VICENTE FRANCISCO Q. FIRMALO, MD PLASTIC AND RECONSTRUCTIVE SURGERY

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1 WIRELESS MICROCURRENT STIMULATION PIONEERING PHILIPPINE EXPERIENCE VICENTE FRANCISCO Q. FIRMALO, MD PLASTIC AND RECONSTRUCTIVE SURGERY

2 INTRODUCTION Human Anatomy is affected by underlying physiologic processes

3 INTRODUCTION Electric potential difference between the epidermis and underlying dermis and subcutaneous tissues Skin battery Kambouris et. Al Poltawski and Watson 2009 Mercola and Kirsch 1995

4 WOUND PHYSIOLOGY Significant changes in the edges of the wound and the periwound area 3mm away Kloth 2005

5 WMCS Wetling Product sheet

6 ADVANTAGES OF WMCS Can be used as adjunctive treatment, non-exclusive modality No touch technique comfort, pain, pediatric friendly Wide range of applicability burns, chronic wounds, others Relative portability Ease of use

7 DISADVANTAGES OF WMCS Electric power dependence

8 PIONEERING PHILIPPINE EXPERIENCE WITH WMCS TERTIARY HOSPITAL BURN UNIT NON-HEALING WOUND

9 TERTIARY HOSPITAL BURN UNIT 6 patients with superficial partial thickness to deep partial thickness burns Dressed with Silver Sulfadiazine on NSS-moistened sterile gauze Adjunctive treatment with Wireless MicroCurrent Stimulation x 1 hour daily on burn site

10 AD 28M ELECTRICAL BURN, 27% TBSA, FACE, UPPER EXTREMITY, RIGHT, LOWER EXTREMITIES

11 DAY1 OF WMCS RIGHT ARM(3 RD POST BURN DAY)

12 DAY1 OF WMCS RIGHT ARM

13 DAY 3 RIGHT ARM

14 DAY 5 OF WMCS RIGHT ARM

15 DAY 10 RIGHT ARM OF WMCS

16 DAY 10 RIGHT ARM OF WMCS

17 10 DAY COMPARATIVE PICTURES

18 DAY 1 OF WMCS RIGHT LEG & THIGH

19 DAY 3 RIGHT LEG & THIGH OF WMCI

20 DAY 5 RIGHT LEG & THIGH OF WMCS

21 DAY 5 RIGHT THIGH OF WMCS

22 DAY 5 OF WMCS RIGHT THIGH

23 DAY 9 OF WMCS RIGHT LEG

24 DAY 13 OF WMCS RIGHT LEG

25 DAY 13 OF WMCS RIGHT THIGH

26 DAY 13 RIGHT THIGH OF WMCS

27 BL 44M SCALD BURN, 9% TBSA, DPT TO FT BURN, RIGHT; SPT-DPT, LEFT

28 DAY 1 WMCS

29 DAY 4 WMCS

30 Day 6 WMCS

31 Day 6 WMCS

32 DG 32M ELECTRICAL BURN, 30% TBSA, UPPER EXTREMITY, RIGHT, BACK, TRUNK

33 Day 1 WMCS

34 Day 4 WMCS

35 Day 6 WMCS

36 GR 27M FLAME BURN 26.5% TBSA SPT-DPT POSTERIOR NECK, BACK, BILATERAL UPPER AND LOWER EXTREMITY

37 DAY 1 WMCS

38 6 DAYS POST WMCS

39 COMPARATIVE PICTURES

40 JD 2M SCALD BURN 33% TBSA SPT-DPT FACE, ANTERIOR TRUNK, POSTERIOR TRUNK, BILATERAL UPPER EXTREMITIES, LEFT GLUTEAL AREA

41 1 DAY POST WMCS

42 7 DAYS POST WMCS

43 10 DAYS POST WMCS

44 14 DAYS POST WMCS

45 RL 7F 30% TBSA DPT TO FULL THICKNESS FLAME BURN TO ANTERIOR THORACOABDOMINAL AREA, MEDIAL RIGHT ARM, ANTEROLATERAL RIGHT THIGH

46

47 Multiple debridement, tangential excision done

48

49 Split Thickness Skin grafting was done

50

51

52 5 DAYS POST SKIN GRAFTING

53 2 WEEKS APART WMCS 3X/WK

54 2 WEEKS APART WMCS 3X/WK

55 AB 34M A CASE REPORT IN A DIABETIC, HYPERTENSIVE USING WMCS

56 ON CONSULT S/P SAUCERIZATION FOR CARBUNCLE 2 MONTHS PRIOR TO CONSULT (9.7 X 5.1 CMS)

57 DEBRIDEMENT WMCS ONCE A WEEK

58 FIRST WEEK POST DEBRIDEMENT (8.5 X 4 CMS)

59 SECOND WEEK POST DEBRIDEMENT (7.4 X 1.5CMS)

60 THIRD WEEK POST DEBRIDEMENT ( 6.8 X 1.4 CMS)

61 FOURTH WEEK POST DEBRIDEMENT ( 5 X 1 CMS)

62 FIFTH WEEK POST DEBRIDEMENT ( 2 X 0.4 CMS)

63 ALGORITHM VS JIGSAW PUZZLE APPROACH

64 DISCLOSURE Not affiliated with nor have any stake in the company of Wetling or its distributors Did not receive any financial support for these cases

65 STATUS OF WOUND CARE IN THE PHILIPPINES

66 TRADITIONAL MEDICINE IN THE PHILIPPINES Traditional Medicine Act Akapulko (Cassia alata) a medicinal plant called "ringworm bush or schrub" and "acapulco" in English, this Philippine herbal medicine is used to treat tinea infections, insect bites, ringworms, eczema, scabies and itchiness. Ampalaya (Momordica charantia) Common names include "bitter melon " or "bitter gourd " in English. This Philippine herbal medicine has been found to be effective in the treatment of diabetes (diabetes mellitus), hemofrhoids, coughs, burns and scalds, and being studied for anti-cancer properties. Bawang (Allium sativum) Common name in english is "Garlic". Bawang is a used in Philippine herbal medicine to treat infection with antibacterial, antiinflammatory, anti-cancer and anti-hypertensive properties. It is widely used to reduce cholesterol level in blood. Bayabas (Psidium guajava) - "Guava" in English. A Philippine herbal medicine used as antiseptic, anti-inflammatory, anti-spasmodic, antioxidant hepatoprotective, anti-allergy, antimicrobial, antiplasmodial, anti-cough, antidiabetic, and antigenotoxic in folkloric medicine. Lagundi (Vitex negundo) - known as "5-leaved chaste tree" in english is used in Philippine herbal medicine to treat cough, colds and fever. It is also used as a relief for asthma & pharyngitis, rheumatism, dyspepsia, boils, and diarrhea. Niyog-niyogan (Quisqualis indica L.) - is a vine known as "Chinese honey suckle". This Philippine herbal medicine is used to eliminate intestinal parasites. Sambong (Blumea balsamifera)- English name: "Ngai camphor or Blumea camphor" is a Philippine herbal medicine used to treat kidney stones, wounds and cuts, rheumatism, anti-diarrhea, anti spasms, colds and coughs and hypertension Tsaang Gubat (Ehretia microphylla Lam.) - English :"Wild tea" is a Philippine herbal medicine taken as tea to treat skin allergies including eczema, scabies and itchiness wounds in child birth Ulasimang Bato Pansit-Pansitan (Peperomia pellucida) is a Phillipine herbal medicine known for its effectivity in treating arthritis and gout. Yerba Buena (Clinopodium douglasii) - commonly known as Peppermint, is used in Philippine herbal medicine as analgesic to relive body aches and pain due to rheumatism and gout. It is also used to treat coughs, colds and insect bites

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