Electric Stimulation as an Effective Adjunctive Therapy for Diabetic Foot Ulcer: A Meta-analysis of Randomized Controlled Trials

ABSTRACT OBJECTIVE To evaluate the effectiveness of electric stimulation (ES) for diabetic foot ulcer (DFU) treatment. METHODS The authors searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases for randomized clinical trials published through March 2019 that compared the efficacy of ES and standard wound care (SWC) versus SWC alone for DFU treatment. The outcomes were pooled using a random-effects model. RESULTS Of the 145 randomized clinical trials initially identified, seven studies (with a total of 274 patients) met the inclusion criteria. The percentage decrease in ulcer area at 4 weeks was significantly greater in patients treated with ES and SWC than SWC alone (standardized mean difference, 1.09; 95% confidence interval, 0.62-1.57; P < .001). The ulcer healing rate at 12 weeks was also significantly faster in the ES group (risk difference, 0.19; 95% confidence interval, 0.06–0.32; P = .005). Subgroup analysis showed comparable efficacies with different waveforms (monophasic vs biphasic). CONCLUSIONS Electrical stimulation appears to be an effective adjunctive therapy for accelerating DFU healing.