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

INTRODUCTION Human Anatomy is affected by underlying physiologic processes

INTRODUCTION Electric potential difference between the epidermis and underlying dermis and subcutaneous tissues Skin battery Kambouris et. Al. 2014 Poltawski and Watson 2009 Mercola and Kirsch 1995

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

WMCS Wetling Product sheet

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

DISADVANTAGES OF WMCS Electric power dependence

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

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

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

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

DAY1 OF WMCS RIGHT ARM

DAY 3 RIGHT ARM

DAY 5 OF WMCS RIGHT ARM

DAY 10 RIGHT ARM OF WMCS

10 DAY COMPARATIVE PICTURES

DAY 1 OF WMCS RIGHT LEG & THIGH

DAY 3 RIGHT LEG & THIGH OF WMCI

DAY 5 RIGHT LEG & THIGH OF WMCS

DAY 5 RIGHT THIGH OF WMCS

DAY 5 OF WMCS RIGHT THIGH

DAY 9 OF WMCS RIGHT LEG

DAY 13 OF WMCS RIGHT LEG

DAY 13 OF WMCS RIGHT THIGH

DAY 13 RIGHT THIGH OF WMCS

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

DAY 1 WMCS

DAY 4 WMCS

Day 6 WMCS

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

Day 1 WMCS

Day 4 WMCS

Day 6 WMCS

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

DAY 1 WMCS

6 DAYS POST WMCS

COMPARATIVE PICTURES

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

1 DAY POST WMCS

7 DAYS POST WMCS

10 DAYS POST WMCS

14 DAYS POST WMCS

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

Multiple debridement, tangential excision done

Split Thickness Skin grafting was done

5 DAYS POST SKIN GRAFTING

2 WEEKS APART WMCS 3X/WK

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

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

DEBRIDEMENT WMCS ONCE A WEEK

FIRST WEEK POST DEBRIDEMENT (8.5 X 4 CMS)

SECOND WEEK POST DEBRIDEMENT (7.4 X 1.5CMS)

THIRD WEEK POST DEBRIDEMENT ( 6.8 X 1.4 CMS)

FOURTH WEEK POST DEBRIDEMENT ( 5 X 1 CMS)

FIFTH WEEK POST DEBRIDEMENT ( 2 X 0.4 CMS)

ALGORITHM VS JIGSAW PUZZLE APPROACH

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

STATUS OF WOUND CARE IN THE PHILIPPINES

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