Wolfgang Schaden

Objectives: Fournier’s gangrene is an aggressive frequently fatal polymicrobial soft tissue infection of perineum and external genitalia requiring immediate radical surgery. Postoperative management includes mesh-graft and skin-flaps. We used low intensity shock wave therapy (Li-ESWT) in the management of wound healing following Fournier`s gangrene...

Background and Aims In chronic ischaemic heart failure, revascularisation strategies control symptoms but are less effective in improving left ventricular ejection fraction (LVEF). The aim of this trial is to investigate the safety of cardiac shockwave therapy (SWT) as a novel treatment option and its efficacy in increasing cardiac function by indu...

This case report describes a novel and unique combination of both electromagnetic and electrohydraulic focused extracorporeal shockwave therapy (ESWT) and extracorporeal magnetotransduction therapy (EMTT) for accelerated healing in a calcaneus epiphyseal fracture with delayed healing in an adolescent Parkour athlete. After a 2.5m jump, the 14-year-...

Einleitung: Die Befunderhebung stellt die Basis aller handtherapeutischen Maßnahmen dar, wobei unterschiedliche Barrieren diesen Prozess erschweren. Der MoKö wurde entwickelt, um diese Herausforderungen zu bewältigen. Er bietet eine klare Auswahl und Anordnung verschiedener Assessments und stellt Messergebnisse übersichtlich visuell dar. Methode: Z...

Objectives: Wound healing is a complex process that involves inflammation, proliferation, and tissue remodeling to restore damaged tissue integrity. Chronic wounds and ulcers, with incomplete healing and a high risk of recurrence, pose significant challenges to conventional treatments. Extracorporeal Shock Wave Therapy (ESWT) has emerged as a promi...

The loss of peripheral sensation due to polyneuropathy, incomplete spinal cord injury, or amputation dramatically impacts quality of life, primarily due to mental and physical challenges. Missing afferent signals may trigger maladaptation in the sensorimotor cortex and eventually phantom pain. Peripheral blood vessels may degenerate, and axons of p...

IntroductionWithin the last few decades, focused high-energy extracorporeal shockwave therapy (ESWT) has proven to be an effective alternative to standard of care revision surgery in delayed healing fractures or manifest non-unions in various anatomical regions.Materials and methodsA retrospective multi-variant analysis of an open prospective, sing...

A delay or failure to heal is the most common possible complication in clavicle fractures, especially in cases primarily treated conservatively. As the current standard therapy, surgical revision achieves good healing results, but is associated with potential surgery-related complications. Shockwave therapy as a non-invasive therapy shows similar r...

Background The pathological mechanism in acute spinal cord injury (SCI) is dual sequential: the primary mechanical lesion and the secondary injury due to a cascade of biochemical and pathological changes initiated by the primary lesion. Therapeutic approaches have focused on modulating the mechanisms of secondary injury. Despite extensive efforts i...

Background The aims of this study are to determine (i) SARS-CoV-2 antibody positive employees in Austrian trauma hospitals and rehabilitation facilities, (ii) number of active virus carriers (symptomatic and asymptomatic) during the study, (iii) antibody decline in seropositive subjects over a period of around 6 months, (iv) the usefulness of rapid...

Chronische Wunden führen für die Betroffenen und ihr direktes Umfeld in der Regel zu starken physischen und psychischen Belastungen. Auch für Behandelnde sind sie immer noch eine große Herausforderung, und ihre direkten und indirekten Kosten belasten das Gesundheitssystem erheblich. Im Traumazentrum Wien wird die Extrakorporale Stoßwellentherapie (...

Context: On March 11, the World Health Organization (WHO) announced the current corona virus disease 2019 (COVID-19) outbreak as a pandemic. The first laboratory-confirmed case of COVID-19 in Austria was announced on February 27, 2020. Since then, the incidence of infection followed an exponential increase until a complete lockdown in March 2020. T...

Background: The pathological mechanism in acute spinal cord injury (SCI) is dual sequential: the primary mechanical lesion and the secondary injury due to a cascade of biochemical and pathological changes initiated by the primary lesion. Therapeutic approaches have focused on modulating the mechanisms of secondary injury. Despite extensive efforts...

Extracorporeal shockwave therapy is a treatment modality, originally introduced into the clinic as lithotripsie, which has also been successfully used in the last two decades in the non-invasive treatment of delayed or non-healing fractures. Initially, the mechanism of action was attributed to microfracture-induced repair, but intensive basic resea...

Background: Spinal cord injury (SCI) leads to various degrees of life-long functional deficits. Most individuals with incomplete SCI experience a certain degree of functional recovery, especially within the first-year post-injury. However, this is difficult to predict, and surrogate biomarkers are urgently needed. Objective: We aimed to i) determi...

Background Spinal cord injury (SCI) leads to various degrees of lifelong functional deficits. Most individuals with incomplete SCI experience a certain degree of functional recovery, especially within the first-year postinjury. However, this is difficult to predict, and surrogate biomarkers are urgently needed. Objective We aimed to (1) determine...

Context: On March 11, the World Health Organization (WHO) announced the current corona virus disease 2019 (COVID-19) outbreak as a pandemic. The first laboratory-confirmed case of COVID-19 in Austria was announced on February 27, 2020. Since then, the incidence of infection followed an exponential increase until a complete lockdown in March 2020. T...

Extracorporeal shockwave therapy showed a pronounced effect on bone mass in previous animal studies. We showed in this pilot study that a single treatment with unfocused shockwave therapy in unselected patients does not show side effects. Although our study did not show any effect of shockwave on BMD, the limited sample size does not definitively e...

There is dual sequential pathological mechanism in acute spinal cord injury (SCI): the primary mechanical lesion and the secondary injury due to a cascade of biochemical and pathological changes initiated by the primary lesion. Therapeutic approaches have focused on modulating the mechanisms of secondary injury. Despite extensive efforts in the tre...

Manche Wunden widerstehen hartnäckig jedem Behandlungsversuch. Solche chronische Wunden bereiten nicht nur Schmerzen, sondern können auch zu einer psychischen und finanziellen Belastung werden. Umso wichtiger ist hier eine moderne, multidisziplinäre Wundtherapie. In diesem Behandlungskonzept sollte auch die extrakorporale Stoßwellentherapie nicht f...

Introduction Scaphoid nonunion remains challenging for hand surgeons. Several treatment options are available such as: non-vascularized or vascularized bone grafting, with or without additional stabilization. In the last few decades, extracorporeal shockwave therapy (ESWT) has become an established procedure for treating delayed and nonunions. Purp...

Background Mechanical stimulation of acute ischemic myocardium by shock wave therapy (SWT) is known to improve cardiac function by induction of angiogenesis. However, SWT in chronic heart failure is poorly understood. We aimed to study whether mechanical stimulation upon SWT improves heart function in chronic ischemic heart failure by induction of...

Data S1. Supplemental methods.

Numerous studies have proven that extracorporeal shockwave therapy (ESWT) is effective in the noninvasive treatment of delayed healing fractures and nonunions. Imposing shockwave therapy as first-line treatment for the above-mentioned indications could significantly reduce costs and surgery associated complications. Further applications comprising...

Increasing evidence suggests that extracorporeal shockwave treatment (ESWT) is safe and effective for treating several musculoskeletal disorders. Two types of technical principles are usually included in ESWT: focused ESWT (F-ESWT) and radial pressure waves (RPW). These 2 technologies differ with respect to their generation devices, physical charac...

Skin grafting is one of the most common treatment options for permanent replacement of lost skin. Successful healing and engraftment is destined by degree of ischemia, angiogenesis and inflammation in the graft tissue. Exrtacorporeal shockwave therapy (ESWT) has been shown to have beneficial effects in soft tissue wounds through increase in perfusi...

Hintergrund: Physikalische Reizserien konnen zur Aktivierung adaptationsphysiologischer Mechanismen fuhren. Mechanotransduktion, die Ubertragung mechanischer Reize auf Gewebe, Zellen und Extrazellularmatrix (z.B. durch Massagen, Ultraschalltherapie, Kraft- und Vibrationstraining, Stoswellentherapie) mit Transduktion in eine biologische Antwort/Reak...

The complex yet natural biological effect of aging is a multidimensional process influenced by both intrinsic and extrinsic factors alike and impacts each individual differently. Clinical changes noted in the face and neck regions are a combination of aesthetic appearance (wrinkles), structural (muscle atrophy / sarcopenia) and functional (vocal we...

The complex yet natural biological effect of aging is a multidimensional process influenced by both intrinsic and extrinsic factors alike and impacts each individual differently. Clinical changes noted in the face and neck regions are a combination of aesthetic appearance (wrinkles), structural (muscle atrophy / sarcopenia) and functional (vocal we...

Skeletal muscles (SM) composed of post-mitotic multinucleated myofibers are responsible for contraction and force generation for balance and locomotion. SM simultaneously have metabolic, auto-para and endocrine functions responsible for a myriad of homeodynamics 1-5 , and are highly capable of efficient regeneration under physiological conditions....

Discusses a case study on the use of electrohydraulic shockwave treatment to assist an injured soccer player 'Return To Play' in the soonest possible time: safely and at optimal playing capacity. **Full abstract and slides will be posted and available after the conference.

This case study discusses the clinical outcomes of a 16 year old male (weigh: 76 kgs; height: 180cm) right footed centre-back, playing regional and national youth level soccer. The injury involved the strain of the right proximal hamstring reported as a sudden occurrence when sprinting during a game. The injury was initially managed by: rest, ice,...

Background: The objective of the presented study is to investigate in vitro effects of low energy extracorporeal shockwave therapy (ESWT) on the keratinocytes and their metabolic and proliferative properties for their therapeutic applications. Materials: Primary culture of keratinocytes was isolated from clinical samples and after passaging into 12...

Fracture non-unions are still a challenging problem in orthopedics. The treatment of non-unions remains highly individualized, complex, and demanding. In most countries the surgical approach with debridement of the non-union gap, anatomical reduction and appropriate osteosynthesis along with autologous bone grafting is considered as the standard of...

The objective of presented study was to evaluate in vitro effects of extracorporeal shockwave therapy (ESWT) on the keratinocyte morphology, cytoskeleton and mitotic activity. To determine in vitro effects of ESWT on keratinocytes, we applied 100 pulses with an energy flux density 0.1 mJ/mm2 and a frequency of 1 Hz at a distance of 5 cm between the...

The effect of non-invasive extracorporeal shockwaves on pulpal blood flow in orthodontic patients who have undergone active treatment was investigated. Seventy-two adult patients were enrolled in the clinical trial and allocated by block randomization to a treatment or a placebo group at a 1:1 ratio. The patients were required to be otherwise healt...

Diabetic foot ulcers (DFUs) are among the most common foot disorders with ulceration, infection, and gangrene that may ultimately lead to lower extremity amputation. The goals of treatment include the control of diabetes and proper shoe wear. An effective therapy and appropriate foot care are important in wound healing in DFUs. Recently, extracorpo...

AimThis RCT investigated the effect of non-invasive extracorporeal shockwaves on tooth mobility in orthodontic patients after active treatment.Materials and methodsSeventy-two adult patients were included in the study. Immediately after active orthodontic treatment, patients were assigned to a treatment or a placebo group based on block randomizati...

The objective of presented study was to evaluate in vitro effects of extracorporeal shockwave therapy (ESWT) on the keratinocyte morphology, cytoskeleton and mitotic activity. To determine in vitro effects of ESWT on keratinocytes, we applied 100 pulses with an energy flux density 0.1 mJ/mm2 and a frequency of 1 Hz at a distance of 5 cm between the...

Delayed/nonhealing or chronic wounds constitute an exceptional circumstance for each patient affected, impairing quality of life significantly. Intensive treatment is required and imparts an enormous burden on society in terms of lost productivity and healthcare costs. Experimental studies treating ischemic flaps with extracorporeal shock waves sho...

Introduction In this randomized, placebo-controlled clinical trial, we investigated the effect of noninvasive extracorporeal shock waves on the stability of temporary anchorage devices (TADs) under orthodontic loading. Methods Thirty adult orthodontic patients of the Bernhard Gottlieb University Clinic in Vienna, Austria, were enrolled in this cli...

Previously we have shown that epicardial shock-wave therapy improves left ventricular ejection fraction (LVEF) in a rat model of myocardial infarction. In the present experiments we aimed to address the safety and efficacy of epicardial shock-wave therapy in a preclinical large animal model and to further evaluate mechanisms of action of this novel...

This randomized clinical trial investigated the effect of extracorporeal shock waves on the amount of orthodontic tooth movement and periodontal parameters. Twenty-six adult orthodontic patients participated in this clinical trial; all of them receiving lower second molar mesially directed movement. The fixed orthodontic device included superelasti...

An apparatus for generating pressure pulse/shock waves (PP/SWs) is disclosed which comprises a pressure pulse/shock wave (PP/SW) source, a housing enclosing said PP/SW source, and an exit window from which wave fronts of waves generated by said PP/SW source emanate. The wave fronts have plane, nearly plane, convergent off target or divergent charac...

Purpose: Shock waves were shown to induce angiogenesis in ischemic myocardium in rodent models. In the present experiments we aimed to address safety and efficacy of direct epicardial shock wave therapy in a preclinical large animal model and to further evaluate mechanism of action of this novel therapy. Methods: Four weeks after left anterior desc...

It has long been thought that the effectiveness and efficiency of physical therapy would improve if our understanding of the cell biology/biochemistry that participates in mechanics could be improved. Traditional physical therapy focuses primarily on rehabilitation, but recent developments in mechanobiology that illuminated the effects of physical...

Unfocused extracorporeal shock waves (UESW) have been shown to have an anabolic effect on bone mass. Therefore we investigated the effects of UESW on bone in osteoporotic rats with and without anti-resorptive treatment. Twenty-week-old rats were ovariectomized (n = 27). One group was treated with saline and another group with Alendronate (ALN) 2.4 ...

Objectives: Shock waves have been shown to induce recruitment of intravenously injected endothelial progenitor cells to ischemic hind limbs in rats. We hypothesized that shock wave treatment as sole therapy would induce angiogenesis in this ischemia model and would lead to mobilization of endogenous endothelial (progenitor) cells. Methods: A tot...

Objectives CD133pos cells are currently evaluated for use in cardiac cell therapy. We hypothesized that they exert their beneficial effects in a paracrine manner and investigated this in a cell culture ischaemia model. Furthermore, we checked whether purified CD133pos cells perform better than non-fractionated mononuclear cells (MNC). Methods CD133...

For almost 30 years, extracorporeal shock wave therapy has been clinically implemented as an effective treatment to disintegrate urinary stones. This technology has also emerged as an effective noninvasive treatment modality for several orthopedic and traumatic indications including problematic soft tissue wounds. Delayed/nonhealing or chronic woun...

Wound healing disturbances and in particular chronic wounds are increasing worldwide and necessitate an interdisciplinary approach. Based on observations of an osteoinductive effect in patients receiving lithotripsy, shockwave therapy gains increasing interest and implementation in trauma and orthopedic patients suffering from e.g. tendinopathies a...

As extracorporeal shock wave therapy (ESWT) can enhance healing of skin graft donor sites, this study focused on shock wave effects in burn wounds. A predefined cohort of 50 patients (6 with incomplete data or lost to follow-up) with acute second-degree burns from a larger study of 100 patients were randomly assigned between December 2006 and Decem...

Soft tissue wound healing is a complex and well-orchestrated sequence of events on multiple biological levels involving systemic, cellular, and molecular signals. The physiological process of wound healing leads to full tissue repair and regeneration with nearly complete restoration of tissue integrity and functionality. Wounds, particularly among...

Possible effects of comorbidities and of different wound etiologies on the success of extracorporeal shock wave therapy (ESWT) of chronic soft tissue wounds were investigated. From September 2003 until February 2007, 282 patients, being previously treated unsuccessfully were enrolled. Treatment consisted of ESWT occurring at defined intervals. At e...

To assess the time-dependent treatment effects of extracorporeal shock wave therapy (ESWT) in a standard rodent ischemic epigastric flap model. ESWT has been shown to accelerate tissue repair in acute and chronic wounds and improve graft survival, but the mechanism remains incompletely understood. Shock waves at 0.1 mJ/mm and 5 impulses/s (total 30...

predictive models permitting individualized prognostication for patients with fracture nonunion are lacking. The objective of this study was to train, test, and cross-validate a Bayesian classifier for predicting fracture-nonunion healing in a population treated with extracorporeal shock wave therapy. prospectively collected data from 349 patients...

Extracorporeal shock waves are known to stimulate the differentiation of mesenchymal stem cells toward osteoprogenitors and induce the expression of osteogenic-related growth hormones. The aim of this study was to investigate if and how extracorporeal shock waves affected new bone formation, bone microarchitecture, and the mechanical properties of...

Extracorporeal shock wave therapy may enhance revascularization and repair of healing soft tissue. Between January 2006, and September 2007, 28 patients with acute traumatic wounds and burns requiring skin grafting were randomly assigned in a 1:1 fashion to receive standard topical therapy (nonadherent silicone mesh [Mepitel, Mölnlycke Health Care]...

The Combat Wound Initiative (CWI) program is a collaborative, multidisciplinary, and interservice public-private partnership that provides personalized, state-of-the-art, and complex wound care via targeted clinical and translational research. The CWI uses a bench-to-bedside approach to translational research, including the rapid development of a h...

The current "gold standard" for treatment of chronic fracture nonunion in the metaphyseal-diaphyseal region of the fifth metatarsal is intramedullary screw fixation. Complications with this procedure, however, are not uncommon. Shock wave therapy can be an effective treatment for fracture nonunions. The purpose of this study was to evaluate the saf...

Delayed and nonunion of the tibia are not uncommon in orthopaedic practice. Multiple methods of treatment have been developed with variable results. The objective of this study was to define disease-specific and treatment-related factors of prognostic significance in patients undergoing shock wave therapy for tibia nonunion. Retrospective analysis....

Soft tissue wound healing is a complex and well-orchestrated sequence of events on multiple biological levels involving systemic, cellular, and molecular signals. The physiological process of wound healing leads to full tissue repair and regeneration with nearly complete restoration of tissue integrity and functionality. Wounds, particularly among...

Extracorporeal shock wave therapy (ESWT) influences the differentiation of bone marrow stroma cells towards osteoprogenitors and increases the expression of several growth factors. To assess whether unfocused ESWT might serve as a treatment for osteoporosis, we examined the bone architecture dynamics of ESWT-treated and untreated rat tibiae using i...

Low energy shock wave therapy has developed as a treatment standard or alternative therapy for a variety of orthopaedic and soft tissue diseases. In experimental studies it shows very promising results for the treatment of ischemic heart disease. Sergei V. Jargin reported on a device on the basis of a modified lithotripter that is currently used in...

Direct application of low-energy unfocused shock waves induces angiogenesis in ischemic soft tissue. The potential effects of epicardial shock wave therapy applied in direct contact to ischemic myocardium are uncertain. For induction of ischemic heart failure in a rodent model, a left anterior descending artery ligation was performed in adult Sprag...

Wound healing disorders after vein harvesting for coronary artery bypass graft surgery increase morbidity and lower patient satisfaction. Low-energy shock wave therapy (SWT) reportedly improves healing of diabetic and vascular ulcers by overexpression of vascular endothelial growth fractor and downregulation of necrosis factor kappaB. In this study...

We have recently demonstrated that extracorporeal shock-wave therapy (ESWT) is effective in promoting the healing of dermal wounds and in regenerating alveolar bone lost through periodontal disease. The objective of the present study was to determine any antibacterial effect of ESWT on oral bacteria. Monoculture suspensions of 6 bacterial species w...

Unlabelled: Periodontal inflammation with alveolar bone resorption is a hallmark of periodontitis. We hypothesized that extracorporeal shock wave therapy (ESWT) could promote the regeneration of alveolar bone following Porphyromonas gingivalis-induced periodontitis in rats. Rats were infected with P. gingivalis for 10 wks, which caused alveolar bo...

Nonhealing wounds are a major, functionally-limiting medical problem impairing quality of life for millions of people each year. Various studies report complete wound epithelialization of 48 to 56% over 30 to 65 d with different treatment modalities including ultrasound, topical rPDGF-BB, and composite acellular matrix. This is in contrast to compa...