Novel techniques to enhance wound healing

Wound healing is a complex, dynamic and multifaceted biological process. Wound repair is mainly similar at all anatomical sites and can be divided into four major phases including hemostatic phase, inflammatory phase, proliferative phase and remodeling phase. Interrupted or failure during healing process can lead to chronic wound healing. Chronic wound healing is the most common complication in veterinary practice. This condition leads to painful, uncomfortable and later consequently died, as well as leads time consuming and cost of treatment. Currently, physical therapy modalities in the wound healing process have been developed and widely used for adjunctive therapy in veterinary medicine, including electrical stimulation, shockwave therapy, ultrasound therapy and low intensity laser therapy to enhance wound healing. The biological effects of electrical stimulation are result of exogenous electrical signals and are amplifying the biological signal into target tissue. The mechanism of shockwave therapy and ultrasound therapy are the consequence of cavitation phenomenon, activated cellular activity, and increase tissue perfusion. Meanwhile, mean mechanism of low intensity laser therapy is known to supply direct biostimulative light energy to target cells, and to initiate cellular processes. These modalities deliver physical energy to produce therapeutic biological effect, especially inflammatory phase and proliferative phase. Importantly, the biological effects produced by these modalities are including supported the proper environment for healing process, increasing phagocytosis by macrophages, leukocyte adhesion, growth factor production, angiogenesis, collagen synthesis, fibroblast synthesis and granulation tissue formation. In additions, physical energy may affect into the remodeling stage by increasing wound breaking strength.