Effects of Extracorporeal Shockwave Therapy on Wound Healing in Rats.

BACKGROUND: Wound healing remains a major challenge in orthopedic surgeries involving thin soft-tissue injuries, such as calcaneal fractures and open wounds. Recent advancements, such as negative pressure wound therapy, have demonstrated efficacy but have practical limitations, such as patient immobility and fall risk, restricting their broader application. Extracorporeal shockwave therapy, recognized by the International Society for Medical Shockwave Treatment, has shown potential in treating complex wounds, ulcers, and burns. However, the mechanism through which extracorporeal shockwave therapy accelerates wound healing is still unclear. In this study, we aimed to investigate the effects of extracorporeal shockwave therapy on wound healing using a rat model. METHODS: We examined the effects of extracorporeal shockwave therapy on wound healing in a Sprague-Dawley rat model. Extracorporeal shockwave therapy was applied to the wound area using a cylindrical device, and histological evaluations, including immunohistochemical staining and real-time polymerase chain reaction analysis, were conducted to assess the effect of extracorporeal shockwave therapy on angiogenesis and tissue repair. RESULTS: Although no significant differences were found in wound contraction or vascular endothelial growth factor R2 (VEGFR2), CD31, or transforming growth factor-β1 (TGF-β1) expression, the histological analysis revealed increased vascularization and tissue regeneration in the extracorporeal shockwave therapy-treated group compared with those in the control group. On day 3, the number of blood vessels and area of CD31-positive cells were significantly higher in the extracorporeal shockwave therapy group than in the control group, with a continued increase in TGF-β1-positive cell count by day 7. CONCLUSIONS: These findings suggest that extracorporeal shockwave therapy may enhance early wound healing by promoting angiogenesis and collagen production. Further research is needed to optimize extracorporeal shockwave therapy protocols and investigate their long-term effects on wound healing.