Low-frequency (2 Hz)
transcutaneous electrical nerve stimulation (
TNS) may produce widespread and prolonged increases in skin temperature in patients with peripheral vascular insufficiency due to improved microcirculation. The method has previously been used successfully to potentiate healing of chronic
ulcers of various etiology. The present report describes a similar study, using
TNS treatment in attempts to accelerate healing of chronic leprous
ulcers that had resisted treatment for several months or years. All other treatment, local and systemic
chemotherapy, and daily regime remained as far as possible unaltered. The study was limited to ulceration in the soft tissue of the foot or lower leg. Eleven
TNS sessions, each of 30 min duration, were applied per week. In 19 patients (6 out- and 13 in-patients), in whom the
TNS treatment was not interrupted, all
ulcers healed completely within a mean of 5.2 weeks (range 3-12 weeks). The mean size of the
ulcers was 5.2 cu.cm (range 0.2-48.3 cu.cm), and they had persisted for a mean of 15.8 months (range 2-60 months). The 'healing index', i.e. the mean reduction of the
ulcer cavity per week, was 1.0 cu.cm/week. The study demonstrates a clear
therapeutic effect for low-frequency
TNS in patients with leprous
ulcers. The mechanisms involved in the accelerated healing are assumed to be increased microcirculation due to sympatho-inhibition and release of endogenous
corticosteroids.