Extracorporeal Shock Wave Therapy for Wound Management: Study


Managing wounds located on the distal (lower) limbs of horses is by far one of the most frustrating and time-consuming jobs of an equine practitioner. Aggressive research efforts have explored tactics to minimize the formation of excessive scar tissue and improve both the functional and cosmetic outcomes, while simultaneously controlling costs. However, progress has been slow.

While other veterinarians have been evaluating the use of extracorporeal shock wave therapy (ESWT) on soft tissue and joint injuries, Scott McClure, DVM, PhD, Dipl. ACVS, and colleagues from the College of Veterinary Medicine at Iowa State University have been looking at the effects of ESWT on wounds.

"In many species, ESWT has been shown to decrease time to healing of soft tissue injuries," said McClure.

In human medicine, for example, ESWT has shown to increase time to epithelialization (the growth of skin over a wound) in patients with partial thickness wounds. The technique is also accepted for the management of diabetic ulcers.


According to McClure, "The exact mechanism by which ESWT increases the rate of wound healing remains unclear; however, it is thought that it may function, at least in part, by increasing the expression of various growth factors that could promote wound healing."

In their study, McClure and colleagues created a 4-cm and 3-cm full-thickness wound on both front and rear cannon bones, respectively, on six healthy horses. The researchers treated one wound on each limb with ESWT, while the other limb was left as an untreated control. They performed the ESWT weekly until they considered the wounds healed.

"While bacterial culture, area of epithelialization, percent of wound contraction, and staining for growth factors were not different between the treated and untreated wounds, treated wounds had significantly shorter time for healing compared to the untreated wounds," McClure said.

Specifically, wounds that were treated with ESWT healed in an average of 76 days. Untreated wounds healed in an average of 90 days.

This study supports the use of ESWT for increasing the rate of wound healing; however, additional research is needed.

"The effect of ESWT on dirtier wounds and chronic wounds also needs to be investigated,' McClure said. "Other areas worthy of more research include the best times to perform ESWT, the best protocol to use, and whether ESWT should be combined with other therapies such as platelet-rich plasma or skin grafting."

The study, "Effects of extracorporeal shock wave therapy on wounds of the distal portion of the limbs in horses," was published in the May 1 edition of the American Journal of Veterinary Research. Co-authors were Dean D. Morgan, DVM; Michael J. Yaeger, DVM, PhD; Jim Schumacher, DVM, MS, Dipl. ACVS; and Richard B. Evans, PhD.

About the Author

Stacey Oke, DVM, MSc

Stacey Oke, MSc, DVM, is a practicing veterinarian and freelance medical writer and editor. She is interested in both large and small animals, as well as complementary and alternative medicine. Since 2005, she's worked as a research consultant for nutritional supplement companies, assisted physicians and veterinarians in publishing research articles and textbooks, and written for a number of educational magazines and websites.

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