Evidence-Based Use of Pulsed Electromagnetic Field Therapy in Clinical Plastic Surgery

Pulsed electromagnetic field (PEMF) technologies have shown usefulness as adjunctive therapy for the treatment of both delayed-union fractures¹ and chronic wounds.² These relatively simple devices use an external, non-invasive PEMF to generate shorts bursts of electrical current in injured tissue without producing heat or interfering with nerve or muscle function. Recently, increased understanding of the mechanism of action of PEMF therapy has permitted technologic advances yielding economical and disposable PEMF devices. With these devices, PEMF therapy has been broadened to include the treatment of postoperative pain and edema in both outpatient and home settings,³ offering the physician a more versatile tool for patient management.

The initial development of PEMF technology and its evolution over most of the last century was marred by poor presentation and, in many cases, insufficient knowledge of the scientific basis of action. However, plastic and reconstructive surgeons have been early adopters of the therapy and pioneers, along with their basic science colleagues, in developing what is now a significant and rigorous body of evidence around the mechanism of action. In this review, we describe the history, development, and eventual transformation of a marginal therapy into a technology that, should it fulfill its promise, will become a standard part of surgical care and may lead to other, more significant therapies for a variety of acute and chronic conditions.