Estrogen Iontophoresis Versus Stem Cell Therapy in the Treatment of Chronic Wound in the Lower Limb

Abstract
Background: Chronic non-healing ulcers present a chal-lenging and demanding scenario to the physical therapists and physician. Over the past decade, new adjuvants for wound healing have been developed that have become readily avail-able to the wound care practitioner.
Purpose: To determine and compare between the effec-tiveness of estrogen iontophoresis as physical therapy modality and stem cell therapy in the treatment of diabetic foot ulcers.
Methods: Forty-five patients who had diabetic foot ulcers for longer than three months. Their ages were ranged from 40-50 years; with mean value 45.99±4.147 years. The patients were selected from El-Maady Military Hospital (Department of General Surgery)in the period between Jan. 2015 and Dec. 2016. Patients who met the selection criteria were divided randomly into three equal groups, Group (A) received estradiol iontophoresis (–ve ) electrode by intensity 1-5mA for 10min,, 3 sessions per week for 4 weeks and medical treatment. Group (B) received stem cell therapy for wound and estradiol that transmitted through iontophoresis (–ve) electrode for 4 weeks. Group (C) received stem cell therapy (using bone marrow-derived fibrocytes).
Measurements: Wound Surface Area (WSA) was assessed by Digital Camera and Image J 1.49. V Computer Software, and wound volume using volumetric method were assessed before treatment and after 4 weeks of treatment.
Results: The findings of this study indicated significant decrease in WSA and wound volume after treatment in all groups A, B and C (p<0.0001). There was significant difference between Group B and C after treatment in WSA and wound volume (with favored results in Group B.
Conclusion: Results showed that estrogen iontophoresis for 4 weeks in combination with stem cell is an effective adjuvant therapy, better that each method alone, in treatment of diabetic foot ulcers through accelerating wound healing and reducing WSA, wound volume.