![]() ![]() Therefore, the importance of initiating research in experimental models should be emphasized because these are the primary studies required to analyze immunohistological variables in tissue. This fact makes it difficult to know what cellular events are responsible for the results obtained in tissue. However, among the 14 articles ( 23, 29– 39) found reporting on the use of TENS in wound healing, only one described an experimental study involving rats ( 23). Surgically induced models have been used to assess the effects of electrophysical resources in tissue repair ( 3, 9– 11, 20– 28). These models offer an understanding of the various processes that may occur in the target tissue, providing microscopic analyses that are not always possible to perform in human subjects ( 17). In contrast, at the base of the pyramid are experimental studies involving a clinically or surgically induced model ( 17– 19). These are the randomized controlled clinical trials that involve thousands of patients and limited data collection known as ‘mega trials’ ( 17– 19). The purpose of the present narrative review is to describe the scientific evidence regarding the effects of TENS on tissue repair with respect to wound healing, the viability of skin flaps and tendinous repair.Īt the top of the pyramid of scientific evidence are systematic reviews and meta-analyses, which comprise the most valid, reliable studies that produce knowledge. This observation led many studies to focus on the effect of TENS on the peripheral vascular system, showing increases in blood flow ( 16) and, therefore, possibly facilitating tissue repair. However, in recent decades, some authors have observed that, in addition to its analgesic effects, TENS can alter skin temperature and increase blood flow ( 2, 7, 14, 15). Since 1965, TENS has become known worldwide and is also considered to be one of the most common therapeutic resources used in clinical practice for the relief of chronic and acute pain. According to this theory, the activation of large-diameter afferent fibres (A-beta fibres) activates local inhibitory mechanisms in the dorsal horn of the spinal cord causing the presynaptic inhibition of nociceptive afferent fibres (A-delta and C) ( 2, 6, 7, 14, 15). The first TENS units were developed ( 6) and soon became popular after the publication of the gate control theory of pain postulated by Melzack and Wall in 1965 ( 13). The common electrical pulses emitted by TENS devices are described as monophasic rectangular, balanced asymmetrical biphasic rectangular, or symmetrical biphasic rectangular the biphasic pulses are the most commonly used ( 9– 12). It is a nonpharmacological, noninvasive, inexpensive, easy to use and widely applied therapeutic modality used in clinical practice ( 1– 4, 8). Transcutaneous electrical nerve stimulation (TENS) consists of a generic application of low-frequency, pulsed electrical currents transmitted by electrodes through the skin surface ( 1– 6) to stimulate the peripheral nerves to produce various physiological effects ( 7). ![]()
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