Effect of extracorporeal shock wave therapy for burn scar regeneration: A prospective, randomized, double-blinded study

Burns. 2021 Jun;47(4):821-827. doi: 10.1016/j.burns.2020.08.009. Epub 2020 Aug 29.

Abstract

Purpose: This study aimed to investigate the regeneration effect of extracorporeal shock wave therapy (ESWT) on hypertrophic scar regeneration using objective measurements.

Methods: This was a double-blinded, randomized, controlled trial of 48 participants who had undergone autologous split-thickness skin grafting (STSG) with same artificial dermis. The ESWT group (n=25) received shock waves with low-energy flux density (0.05-0.30mJ/mm2). The interval between treatments is a 1-week. The ESWT group also received recommended treatment. The control group (n=23) only received standard treatment. We measured skin characteristics before treatment and after 6 weeks for both groups.

Results: No significant intergroup difference was noted at the initial evaluations (p>0.05). The pre- to post-treatment change in the scar thickness (p=0.03) and erythema (p=0.03), greater reduction was found in the ESWT group than control group. The pre- to post-treatment change in the sebum level (p=0.02), more increase was found in the ESWT group. We found no significant differences in the change measurements between the two groups for melanin levels (p=0.62) and transepidermal water loss (TEWL) (p=0.94). The changes (skin distensibility, biological skin elasticity, gross skin elasticity, and skin viscoelasticity) measured with the Cutometer showed no significant differences between the two groups (p=0.87, p=0.32, p=0.37, and p=0.29, respectively).

Conclusion: This is the first report of ESWT on hypertrophic scar after burn using objective tools (melanin, erythema, sebum, TEWL, elasticity and thickness). ESWT has objective beneficial effects on burn-associated scar characteristics.

Keywords: Burn; Extracorporeal shock wave therapy (ESWT); Hypertrophic scar.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Burns / complications
  • Burns / therapy
  • Cicatrix / physiopathology
  • Cicatrix / therapy*
  • Double-Blind Method
  • Extracorporeal Shockwave Therapy / methods
  • Extracorporeal Shockwave Therapy / standards*
  • Extracorporeal Shockwave Therapy / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Regeneration / physiology
  • Republic of Korea