Status and challenges of electrical stimulation use in chronic wound healing: Reviewing chronic wound bioelectricity principles

Non-healing wounds are a soaring clinical and socio-economical need for advanced wound-care techniques. Electrical stimulation is an emerging therapy inspired by the wound endogenous electric field. Promising results of clinical trials encouraged efforts to create wearable stimulation devices, uncover multiple cellular targets and optimize stimulation regimes. However, the field faces a translational bottleneck. This review aims to highlight gaps between in-vivo treatments and in-vitro associated experiments by discussing current knowledge of the generation, characterization, and targets of electrical stimuli. It becomes clear that enabling the translation of this technology will require increasing the complexity of current models for skin endogenous and controlled ion transport, and investigating which stimulus has an optimum effect on cells derived from chronic wound-prone patients.