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According to the 2005 Australian AusDiab Follow-up Study, around 1 million Australians are diagnosed with diabetes with another 16.3% classed as pre-diabetic.
Diabetes is associated with reduced circulation (peripheral vascular disease) and nerve damage (peripheral neuropathy) in the lower extremities.
The current prevalence rate of foot ulcers lies at 1.7% of adults attending a diabetes clinic20.
The non-invasive and quick treatments can easily be integrated into current protocols (i.e. Inflammatory ModulationAfter PACE treatment the wound moves quickly through the inflammatory phase (increase in leukocyte activity) to the cell duplication phase (proliferation) of healing.
Cytokines and ChemokinesInflammatory and pro-angiogenic phases are accompanied by increases of cytokines and chemokines 6 hours after and up to 7 days post-treatment. Growth factor UpregulationPACE treatments apply mechanical forces to the individual cells in the treatment area and thus, creating a biological response called “cellular expression”.
GranulationGranulation or cellular proliferation describes the stage when cells multiply to cover and close the wound.
EpithelializationA recent phase III clinical trial strongly suggests that dermaPACE has an effect in the stabilization, size reduction and with time, complete re-epithelialization of wounds specifically diabetic foot ulcers (DFU). Published by the The International Council of Ophthalmology, the new ICO Guidelines for Diabetic Eye Care offer recommendations for screening and evaluation of people with diabetes for potentially blinding eye problems and treatment of those with diabetic retinopathy and other ocular complications of diabetes.

The Guidelines represent a technical consensus from the ICO Task Force on Diabetic Eye Care. It is likely to be an even greater problem than these figures indicate, as it is estimated that for each person diagnosed with diabetes, another diabetic is undiagnosed. These two factors increase the risk of diabetic or neuropathic wounds in diabetic patients. Such diabetic ulcers can usually be found in the lower limb region and are called diabetic foot ulcers.
Diabetes is estimated to account for approximately half of all non-traumatic amputations 17. PACE treatment results in an increase in perfusion and arteriogenesis, biofilm disruption, a pro-inflammatory response, cytokine and chemokine effects, growth factor upregulation, angiogenesis (new blood vessel formation) and the subsequent regeneration of tissue such as skin, musculoskeletal and vascular structures.
This describes the incidence when the cells produce wound healing proteins called pro-angiogenic growth factors.
VEGF (vascular endothelial growth factors) indicate the growth of new capillaries to allow an improved blood flow in the wound. Research has shown that after PACE treatment, there is a significant increase of proliferative cells which indicates that PACE treatments may accelerate wound granulation.8 Stojadinovic et al (2008) reported marked granulation tissue development on post-treatment day 4. Epithelialization of greater than 90% was demonstrated to have statistical importance at 12 weeks in favour of PACE treated wounds compared with the placebo group.

Unless otherwise stated, all content is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. This makes a total of around 1.7 million Australian diabetics (diagnosed and undiagnosed)15. Saggini et al (2008) reported considerably increased granulation tissue in the wounds of treated patients after shock wave treatment. The total figure of Australians with diabetes and pre-diabetes is estimated at 3.2 million16.
8 Other studies compared ESWT with topical VEGF application in ischemic tissues and shock wave treatment outperformed VEGF application. Overall PACE treated wounds were twice as likely to achieve 90-100% wound closure compared with sham-control patients within 12 weeks.

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