Preventing scar formation on a cellular level

Partial irreversible electroporation—comprised of the repeated delivery of pulsed electric fields—is a new non-invasive, non-heat generating technology that may reduce the development of scars after burns and other traumatic injuries, and is currently under investigation by researchers at the Massachusetts General Hospital, Boston, MA. Most recently, they have found that repeated treatments reduced scarring following burn injuries as well as removed excess skin cells in an animal model of burn injuries.

"We showed that killing some, but not all of the cells in the wound could actually help regenerate skin without scarring," says lead author Alexander Goldberg, PhD, Center for Engineering in Medicine, Massachusetts General Hospital, Boston, MA, and faculty, Porter School of Environmental Studies, Tel Aviv University, Israel.

For the past 5 years, Dr. Goldberg and colleagues have studied the use of pulsed electric field technology, with good results in several applications in preclinical trials, including burn disinfection and skin rejuvenation. Pulsed electric field technology causes the death of cells while inducing the formation of tiny pores on cellular membranes, without generating heat. Surrounding structures are not damaged in the process, which actually induces neighboring cells to proliferate and release tissue growth and repair factors.

"The main difference between this approach and procedures like ultrasound and lasers is that they operate on the whole tissue, while pulsed electric field treatment works on only a cellular level, which we expect will provide more precise treatment results in the future as we are able to target cells specifically," explained Dr. Goldberg.

In this latest study, they assessed the optimal strength and number of pulses necessary to reduce scar formation in rats with burn injuries. Using partial irreversible electroporation, researchers delivered 200 pulses of 250 V with a duration of 70 μs, at 3 Hz. Optimal results were achieved with just five treatment sessions after the injury, spaced 20 days apart, which reduced scar size by 57.9%, and improved overall appearance and structure, as well as the density and direction of collagen fibers.

"The progress of therapies to treat scars has been very slow, with very few new technologies in the area, mostly because of the complexity of the problem and the lack of suitable animal models," said senior author Martin Yarmush, MD, PhD, director of the Massachusetts General Hospital Center for Engineering in Medicine.

"We now need to investigate whether this new technology and approach will show results in human patients, and we are looking for funding to help us design, build and test a device for clinical application," he concluded.