Randomized Control of Extracorporeal Shock Wave Therapy Versus Placebo for Chronic Decubitus Ulceration

Objective: To assess whether extracorporeal shock wave therapy increases the rate of healing in chronic decubitus ulceration.

Design: Double-blind randomized cross-over study.

Setting: A large, long-stay hospital specializing in the management of people with complex neurological disabilities.

Subjects: The total population of available patients with chronic neurological conditions and chronic decubitus ulceration who met the inclusion criteria.

Interventions: Ulcers were randomized into receiving either the extracorporeal shock wave therapy or the placebo for a four-week period, followed by a two-week 'washout' period followed by a four-week period of the cross-over treatment/ placebo.

Main Measures: Measurement of the area of the ulceration. For each observation the average of three measurements were taken.

Results: Nine ulcers (in eight patients) were included in the study: five on the buttocks/sacrum/trochanter and four on the feet/ankles. All those with static chronic ulcers showed improved healing starting 6-8 weeks after the start of extracorporeal shock wave therapy, whether treated first with the placebo or the therapy.

Conclusions: Extracorporeal shock wave therapy has a potential part to play in the treatment of chronic skin ulceration.