Patent Application
20090048635
The present invention relates generally to systems and methods for creating and applying medical electrodes and electrode systems to the body for treating wounds and skin with electrical stimulation and corresponding medical kits.
Medical electrodes have been around for some time. More recently, medical electrodes have been used to treat wounds. For example, patients that suffer from conditions which limit the flow of blood to a wound site are often not able to exhibit a normal wound healing process. Factors that can negatively affect the normal wound healing process include diabetes, impaired circulation, infection, malnutrition, medication, and reduced mobility. Other factors such as traumatic injuries and burns can also impair the natural wound healing process.
Active approaches have been employed to decrease the healing time and increase the healing rates of some wounds and ulcers. It has also been shown that specific types of electrical stimulation will alter the wound environment in a positive way so that the normal wound healing process can occur or in some cases occur in an accelerated fashion.
U.S. Pat. No. 6,631,294 to Andino discloses an electrode system that generates a current flow that envelops and permeates a wound site. The system includes two electrodes, adapted and positioned to cause a current to flow from one electrode through the wound to the other electrode. The system describes preconfigured dressings and electrode systems, in various shapes and sizes. However, wounds can be irregularly shaped and sized, such that a preconfigured system may not optimally treat the wound. Thus there is a need for medical electrodes that are customizable for specific applications.
In view of the foregoing, it is an object of the present invention to provide improved systems and methods for creating and applying medical electrodes to wounds and skin. It is a more particular object of the present invention to provide systems and methods for creating and applying medical electrodes in a desired shape and size depending on the application. It is also an object of the present invention to provide a medical kit that includes components for assembling electrodes and applying electrical stimulation to the electrodes. It is also an object of the present invention to provide a color scoring chart as part of an electrode system to allow a user to compare the color of a wound or skin to the color scoring chart. It is also an object of the present invention to provide improved sensors and sensor configurations as part of an electrode system. It is also an object of the present invention to provide an electrode system where at least two electrodes are configured to be coupled to skin that is not the wound or area that is intended to be treated. It is also an object to provide a control module for an electrode system with improved ports for coupling the control modules to electrodes and sensors. It is also an object of the present invention to provide an electrode as part of a drainage tube.
These and other objects of the invention are accomplished in accordance with the principles of the present invention by providing systems and methods for creating and applying electrodes and electrode systems to wounds or skin areas of different shapes and sizes.
In one embodiment of the present invention, an apparatus is provided for dispensing an electrode to a surface. The apparatus includes a holder, a supply of conductive material, and a dispenser. According to one arrangement, the supply of conductive material is coiled around an element in the holder, and threaded through the holder toward a distal end. The distal end includes a dispenser, which dispenses the conductive material. In one approach, a user holds the holder and presses the dispenser against the skin or wound. As the user moves the holder proximally, the conductive material is dispensed from the dispenser and remains adhered to the skin. The conductive material may be adhesive, or it may include a conductive adhesive layer that adheres to the wound site.
In another embodiment of the present invention, electrode segments may be provided that can be attached together to construct a larger electrode having a selected shape. The electrode segments may be provided in various shapes and sizes, including straight and curved segments. In one approach, a health care professional may construct an electrode that is shaped to substantially surround and follow the edge of the wound. Another electrode may be placed on the wound. A control module may be provided that is configured to apply a voltage potential across the electrodes to apply a therapy.
In other embodiments of the present invention, the electrodes may be provided as part of an electrode system in preformed shapes and sizes for particular applications. The electrode system may include two electrodes that are configured to be applied to a selected body part. The shape of the surfaces of the electrodes may be configured to interface with the selected body part such as to envelope or partially surround a particular wound. The electrode system may be flexible, or it may be semi-rigid. The electrode system may also include a control module for applying a voltage potential across the electrodes. In various examples, the electrode system may be preconfigured for application to a patient's heel, ankle, foot, toe, knee, elbow, wrist, hand, or finger.
In another embodiment of the present invention, a supply of electrode material may be provided in the form of a sheet. The sheet may be cut to a selected size and shape. The sheet may include connection nodes that are configured to electrically couple the sheet to a control module. In one suitable approach, a health care professional may cut a first electrode from the sheet such that the first electrode is substantially the same size and shape as a wound. The center of the first electrode may then be cut out so that the electrode surrounds the center or the entire wound when applied to the wound site. One or more center electrodes may also be cut from the sheet. A center electrode may be placed in the center of the wound. Both the first electrode and the center electrode may be connected to a control module or power supply.
In accordance with another embodiment of the present invention, a color scoring chart may be provided as part of an electrode or an electrode system. The color scoring chart may include a range of colors, and may be a redness scoring system. The color scoring chart allows a practitioner to compare the color of the wound to the colors of the scoring system. The colors of the chart may have corresponding numbers.
In another embodiment of the present invention, a medical kit may be provided that includes components for applying an electrode or an electrode system to a wound or other body location. The medical kit may include any of the electrodes and components described herein. The medical kit may include electrode segments of multiple different sizes and shapes and connectors that can be used for coupling the electrode segments together to form larger electrodes. The medical kit may also include electrodes sized for application to skin and/or wounds. The medical kit may also include control modules for applying a voltage potential across two or more electrodes and for receiving signals from one or more sensors. The control modules may include ports that selectively couple to the electrodes and sensors. The apparatus for dispensing electrodes and the electrode sheets that can be cut to selected sizes may also be provided as part of the medical kit. In addition, the medical kit may include a diagnostic device, gauze, a scalpel, scissors, tape, and a wound exudates absorber.
In accordance with other embodiments of the present invention, multiple sensors may be provided as part of an electrode system. The sensors may be configured to take measurement from different locations. For example, the voltage potential can be measured at different locations in the wound. In addition, the temperature and pH can also be measured by these sensors. The measurements can be used by the control module or a health care professional to monitor and adjust the therapy that is being applied.
In accordance with other embodiments of the present invention, one or more electrodes may be applied to areas outside of a wound site or the skin that is intended to be treated. For example, two electrodes may be applied on opposite sides of a wound. By applying a voltage potential across the two electrodes, a current may be caused to flow through the wound. A third (or more) electrode or a sensor may also be applied to the wound.
In accordance with other embodiments of the present invention, an electrode may be incorporated as part of a drainage tube.
The foregoing and other objects and advantages of the invention will be appreciated more fully from the following further description thereof, with reference to the accompanying drawings.
To provide an overall understanding of the invention, certain illustrative embodiments will now be described with reference to
In accordance with some embodiments of the present invention, electrodes are provided for application to wounds and skin. The electrodes are capable of being configured into various shapes and sizes. This is particularly beneficial for the application of electrodes to different surface contours and irregular shapes. In one embodiment, the electrodes are used as part of an electrode system configured to apply a therapy to wounds and skin. For example, the electrodes of the present invention may be used with the electrode systems of commonly-assigned U.S. Pat. No. 6,631,294 and commonly-assigned U.S. patent application Ser. No. 11/494,819, filed on Jul. 28, 2006, the contents of both of which are hereby incorporated by reference. The electrode system may include a control module and multiple electrodes.
The electrodes of the present invention may be made of thin metal, metallic paint or pigment deposition, metallic foil, conductive hydrogels, or any other suitable conductive material. In one suitable approach, silver may be used as at least part of the material for the electrodes due to its bactericidal properties. In another suitable approach, conductive hydrogels may be used as the material for the electrodes because of their permeability to oxygen and ability to retain water. Hydrogels are generally clear, viscous gels that protect the wound from desiccating. Both oxygen and a humid environment, for example, are needed for the cells in a wound to be viable. In addition, hydrogels can be easily cast into any shape and size. Various types of conductive hydrogels may be employed, including cellulose, gelatin, polyacrylamide, polymethacrylamide, poly(ethylene-co-vinyl acetate), poly(N-vinyl pyrrolidone), poly(vinyl alcohol), HEMA, HEEMA, HDEEMA, MEMA, MEEMA, MDEEMA, EGDMA, methacrylic acid based materials, and siliconized hydrogels. PVA-based hydrogels are inexpensive and easy to form. The conductivity of such hydrogels can be changed by varying the salt concentration within the hydrogels. By increasing the salt concentration within a hydrogel, the conductivity of the hydrogel increases. In addition, the diffusion properties of the hydrogel can be varied as a means of optimizing the transport and conductivity properties of the hydrogel. Parameters such as pore size, which can be affected by the degree of cross linking, and water content, which can be affected by the addition of ionizing monomeric groups such as methacrylic acid or side groups such as urea or amine groups, can be varied to achieve desired hydrogel properties. Bulk water holding properties of the hydrogel can be changed during the gelation process through, for example, the use of the isocyanate reaction with water to generate carbon dioxide thus forming a hydrogel with an open cell structure providing voids for water (like a sponge). This provides the opportunity to design a desired controlled release of moisture to the wound.
The electrodes may include a nonconductive backing layer that may provide support for the electrodes. In addition, the electrodes themselves may have adhesive properties (e.g., hydrogel) or an electrically conductive adhesive may be applied to the surface of the electrodes for attaching the electrodes to a surface such as a wound or skin.
The control module may be coupled to the electrodes to provide a voltage potential across the electrodes. The control module may be the same or substantially similar to the control modules disclosed in commonly-assigned U.S. Pat. No. 6,631,294 and commonly-assigned U.S. patent application Ser. No. 11/494,819, filed on Jul. 28, 2006, which are incorporated by reference herein. In various arrangements, the control module may include a processor, a display, a memory, a power supply, a timer, and a user input device. A user or health care professional may use the control module to select or alter the therapy applied to the wound via the electrodes. The control modules used in accordance with the present invention may provide a closed loop control system where the skin and wound form an integral part of the circuitry. For example, the control modules may be configured to provide a constant current between or voltage across the two or more electrodes applied to the wound and/or skin. In addition, the control modules may be configured to provide a constant current density across an area or range of areas associated with the wound and/or skin.
As illustrated, dispensing element 28 is a rotatable cylinder that is capable of rotating about its center. Dispensing element 28 may have raised sides to keep electrode strip 18 from sliding in either axial direction off of the dispensing element. In another suitable arrangement, dispensing element 28 may be a stationary structure that electrode strip 18 slides against. In such an arrangement, dispensing element 28 may be any suitable shape to facilitate electrode tape 24 from separating from backing 22. For example, dispensing element 28 may be pointed to facilitate separating electrode tape 24 from backing 22.
In one suitable configuration, first and second gears 34 and 36 and their respective supply and receiving elements 14 and 16 are sized and shaped such that the length of electrode strip 18 released from supply element 14 is substantially equal to the length of backing 22 wound around receiving element 16. In another suitable configuration, first and second gears 34 and 36 and their respective supply and receiving elements 14 and 16 are sized and shaped such that the length of electrode strip 18 released from supply element 14 is less than the length of backing 22 wound around receiving element 16. In such a configuration, electrode strip 18 will be caused to undergo tension between supply element 14 and receiving element 16 as electrode tape 24 is being applied. In order to account for the different lengths being supplied and received on supply element 14 and receiving element 16, backing 22 may be made of a flexible material. In another suitable approach, backing 22 may be frictionally coupled to receiving element 16 such that the backing is capable of moving relative to receiving element 16 under a certain amount of force. In another suitable approach, receiving element 16 may be frictionally coupled to second gear 36 such that receiving element 16 is capable of moving relative to second gear 36 under a certain amount of force.
According to one example, a health care professional may apply electrode tape 24 on skin around a wound, to substantially surround a wound. Electrode tape 24 may be flexible such that the health care professional may easily apply the tape in a desired shape. For example, this may be achieved by moving dispensing element 28 of electrode dispenser 12 in the desired shape across the receiving surface.
As described above, supply and receiving elements 14 and 16 are manually operated when the dispensing element 28 of electrode dispenser 12 is manually moved across a surface. In another suitable arrangement, a motor powered by, for example, a battery may be included in housing 20 to automatically advance electrode strip 18. In this arrangement a button may be provided on housing 20 that will turn the motor on and off. This may be useful if the element is being applied to a sensitive wound or skin.
In an alternative embodiment, dispensing element 28 of electrode dispenser 12 may not be included and receiving element 16 may act as both the receiving element and the dispensing element.
Once electrode tape 24 has been applied to a surface, the tape may be cut to separate the applied electrode tape from electrode dispenser 12. Electrode dispenser 12 may be used multiple times to apply electrodes to a surface. The applied electrode tape can then be coupled to a control module using the techniques described further below, including having connection nodes on the electrode tape.
In another embodiment of the present invention, an electrode can be assembled from multiple electrode components to create an electrode of a desired size and shape.
The electrode components may be provided in straight and curved pieces. The curved pieces may be any suitably sized arcs having any selected radius. According to one approach, the curved electrode segments are arcs having angles of 180 degrees or less, having any suitable radius of curvature, including, for example, about 0.5 cm, about 1 cm, about 2 cm, about 4 cm, about 6 cm, about 8 cm, about 10 cm, about 15 cm, about 20 cm, about 30 cm, about 50 cm, about 100 cm, or more than 100 cm. The straight and curved electrode segments may have any suitable length, including, for example, about 0.5 cm, about 1 cm, about 2 cm, about 3 cm, about 4 cm, about 5 cm, or more than 5 cm.
Connector 106 includes protrusions 106a and 106b, and is sized and shaped for interfitting with adjacent receptacles such as receptacles 112b and 114a. As shown in
Center electrode 134 and the surrounding electrode 136 may be connected to the control module 138 via conductive cables 144 and 146. Conductive cables 144 and 146 are connected to the control module and to connector nodes in electrodes 134 and 136. According to one approach, only one electrode component 136a of external electrode 136 is connected to control module 138, and the electrode components 136a-136m are sufficiently attached such that any voltage applied by the control module 138 to external electrode component 136a is substantially equally applied to the entire external electrode 136. In another suitable approach, control module 138 may be connected to two or more electrode components to ensure that the voltage is substantially the same along the entire length of external electrode 136. According to another suitable approach, the electrode components of external electrode 136 may not include connection nodes, and an external electrode attachment device may be used to connect electrode 136 with control module 138.
The foregoing is merely illustrative. The electrode components may be assembled in any suitable size or shape depending on the desired application.
In accordance with another embodiment of the present invention, the dressing may be sprayed or painted onto the wound. The spray dressing may comprise a conductive material which may be in liquid or atomized form that cures on contact or is cured by exposure to an agent or UV energy source. An example of a material that cures on contact is polysaccharide alginate which crosslinks in the presence of calcium ions (Ca can be supplemented if not enough is present in the tissue). An example of a material cured in place by the addition of an agent is PVA (polyvinyl alcohol) upon addition of borate ions. An example of a suitable UV cured material is PVA that has been chemically modified to contain photo initiated cross linking side groups.
The spray dressing may cover the anode and cathode leads or alternatively, the anode and cathode leads may be attached or applied to the spray dressing after the dressing has been cured. According to one example, a sprayed or painted dressing may be particularly useful on burn wounds. Burn wounds are very delicate and can be extremely painful. By using such a sprayed on or painted dressing, pain and tissue damage can be minimized compared with adhesive based tape type dressings.
Removal of hydrogels formed as described above in the alginate example can be facilitated by a wash with a chelating agent such as EDTA (ethylenediamine tetraacetic) or DPTA (diethylenetriaminepentaacetic acid) to remove the Ca and break the cross link.
According to another arrangement, the electrodes may be configured to provide a voltage gradient across the wound without a control module such as control module 138 shown in
In accordance with another embodiment of the present invention, the electrodes may be provided in preformed shapes and sizes for particular applications. The shape of the surfaces of the electrodes may be configured to interface with the selected body part.
The preformed electrode system dressing shown in
In accordance with another embodiment of the present invention, the electrodes may be cut from an electrode sheet into any suitable sizes or shapes.
Electrode sheet 180 may be provided in any selected shape or size. Electrode sheet 180 may, for example, be rectangular with a width of about 2, 5, 10, 20, 30, 50 or more centimeters and a length of about 2, 5, 10, 20, 30, 50, 100 or more centimeters. The width and/or length of the sheet 180 may also be less than about 2 cm. In one suitable approach, electrode sheet 180 may be rolled up for storage. In another suitable approach, electrode sheet 180 may be supplied as a package of multiple sheets.
Connection nodes 182 of electrode sheet 180 may be spaced at any suitable distance on sheet 180. For example, along the width of electrode sheet 180, connection nodes 182 may be positioned about 1, 2, 3, 4, 5, 7, 10, or more centimeters apart, and along the length of electrode sheet 180, connection nodes 182 may be positioned about 1, 2, 3, 4, 5, 7, 10 or more centimeters apart.
In accordance with another embodiment of the present invention, the electrodes may be provided with a means for determining a treatment status for the wound or skin to which they are attached.
The color scoring chart shown in
In accordance with another embodiment of the present invention, a medical kit may be provided that includes components for applying an electrode or an electrode system to a wound site.
Electrode components 242 may be similar to electrode components shown in
Medical kit 230 may include any of the electrodes and components described herein. Medical kit 230 may also include instructions and advice for creating and applying electrodes and applying therapies to the wound and skin. In addition, medical kit 230 may include tools useful for treatment preparation or wound debridement such as gauze, scalpels, tape, wound exudates absorbers such as alginates, and gauze or wound odor absorbers such as charcoal.
Medical kit 230 may also include a diagnostic device. The diagnostic device may be a multi-meter to measure the current and/or voltage or other biosensors to measure, for example, the specific biochemistry of the wound. The kit may also include any items commonly found in first-aid kits, such as surgical tape, alcohol swabs, latex gloves, and bandages.
In accordance with other embodiments of the present invention, sensors may be provided and added to the wound and/or skin surrounding the wound.
Additionally, leads 330, 332, 334, 336, and 338 connect feedback sensors 310, 312, 314, 316, and 318 to control module 308.
According to the illustrative arrangement of
In various examples, measurements from feedback sensors 310, 312, 314, 316, and 318 may be taken while a therapy is being applied or when therapy is not being applied. Measurements taken at different points in time may be compared. For example, sensor measurements may taken while therapy is being applied, and at selected time intervals thereafter. Voltage measurements may be monitored to determine how quickly the voltages change at various locations in the wound, at what level the voltages stabilize, and the length of time it takes for the measurements to stabilize. These measurements may be used by the control module or a medical professional to determine the course of therapy to apply to the wound (e.g., the voltage strength, and the time interval between applications). In one example, the sensor measurements are taken continuously.
Feedback sensors 310, 312, 314, 316, and 318 are shown as individual standalone sensors. In another arrangement, one or more of feedback sensors 310, 312, 314, 316, and 318 may be incorporated into electrodes 302 or 304 or other components of the wound dressing.
In other arrangements, feedback sensors 310, 312, 314, 316, and 318 may be any suitable type of sensor, including, for example, a reactive sensor, an electrochemical sensor, a biosensor, a biochemical sensor, a physical property sensor, a temperature sensor, a sorption sensor, a pH sensor, a voltage sensor, a current sensor, and any suitable combination thereof. Feedback sensors 310, 312, 314, 316, and 318 may be configured to detect any suitable factor or factors that affect the treatment of skin or wound growth, including, for example, the natural current of injury of the wound, the amount of peroxide being generated by an electrode placed in the wound or the amount of peroxide present in the wound bed, the temperature of the wound, and the temperature of the skin surrounding the wound. Feedback sensors 310, 312, 314, 316, and 318 may be configured to detect other treatment factors including chemical levels, the amount of oxygen, the amount of carbon dioxide, pH, fibrium, albumin, sodium salts, up regulation or down regulation of genes, calcium, red blood cells, white blood cells, bacterial fauna, ions, and cations in the wound. Feedback sensors 310, 312, 314, 316, and 318 may be placed in any suitable location on the patient, including on the treated part of the skin, in the center of a wound, on an edge of the wound, or on healthy skin surrounding the wound.
In addition, feedback sensors 310, 312, 314, 316, and 318 may be configured to examine the surface of the electrodes to observe changes over time to determine the chemistry of what is occurring in the wound bed. Feedback sensors 310, 312, 314, 316, and 318 may be configured to detect the liberation of selected growth factors by the wound or surrounding tissue, the liberation of selected ionic species by the wound or surrounding tissue, or the liberation of selected biological chemicals or compounds that relate to the wound or surrounding tissue such as genes.
An illustrative feedback sensor that may be used in accordance with the present invention is shown in
Tip 364 of needle 354 is designed to pierce a top layer of skin or a top layer of a wound. During use on skin, needle tip 364 may be positioned, for example, between about 50 μm and about 200 μm beneath the skin surface, and it may be positioned between about 100 μm and about 150 μm beneath the skin surface. In one example, needle 354 pierces the high resistance stratum corneum of the skin, but not the basement membrane.
Needle tip 364 is sharp, and may have a radius of less than 10 μm. In one arrangement, sensor 350 measures voltage potential.
Sensor 350 shown in
In accordance with other embodiments of the present invention, one or more electrodes may be applied to areas outside of the wound site or area to be treated. For example, two (or more) electrodes may be provided on healthy skin on opposite sides of a wound. By applying a voltage potential across the two electrodes, a current may be caused to flow through the wound site providing a similar beneficial effect as in embodiments where at least one electrode is located in the wound site. One advantage of using electrodes on healthy skin is with regard to sterilization. An electrode placed on healthy skin may not need to be sterilized or may be sterilized to a standard that is lower than the standard for electrodes intended for use in the wound site.
Outside electrodes 406 and 408 may be of any suitable size or shape. As shown in
Electrode system 400 may apply any suitable therapy as described herein. For example, electrode 404 may be used as a cathode in combination with electrodes 406 and 408, which may be used as anodes. The therapy may vary such that electrodes 406 and 408 may alternatively be activated to vary the therapy across the wound. In another suitable approach voltage potential may be applied across electrodes 406 and 408. Electrode 404 may be replaced with a sensor to provide feedback to the control module or may not be included at all. For example, the sensor may be configured to detect electrical, chemical, and biological factors described herein. The control module may respond to the sensor measurements to vary the therapy such as by varying the voltage, current, current density, polarity of the electrodes, or any other suitable aspect of the therapy.
The electrodes of medical kit 440 may be used as either cathodes or anodes either around the wound or in the wound. The specific size and shapes of the electrodes for a wound may be selected as appropriate by a medical professional based on the shape and type of wound. When the electrodes are selected to be placed outside of the wound, the electrodes may be arranged so that there is no space between adjacent electrodes, a small space between adjacent electrodes, or a large space between adjacent electrodes. For example, two electrodes may be selected for placement on opposite sides of the wound. Electrodes 460 and 462 may be used, for example, as cathodes or anodes in the wound in combination with other electrodes outside or surrounding the wound.
Medical kit 440 may also includes one or more control modules 470. In one example, control module 470 may be used as the control module in electrode system 400 shown in
In accordance with other embodiments of the present invention, an electrode may be incorporated as part of a drainage tube. Drainage tubes are typically flexible and malleable tubes used to drain fluids from parts of a patient's body. For example, drainage tubes can be used to drain fluid from surgical wound cavities. The procedure generally involves placing a flexible hollow tube into a patient's body with the end of the tube located at the site to be drained. The opposite end of the tube can be connected to a wound drainage reservoir, which may, for example, be a vacuum drainage bottle or a pump that periodically helps to drain the fluid.
Electrode 464 illustrated in
Electrode drainage tube 464 may be used with one or more other electrodes located away from the electrode tube in accordance with the principles of the present invention. Use of electrode drainage tube 464 may help prevent infection of the opening through which the tube passes and may facilitate healing of the opening and any other surrounding damaged tissue, while at the same time provide drainage for any excess fluid.
Electrode drainage tube 464 may be manufactured using a co-extrusion process. For example, the inner, middle, and outer layer of electrode drainage tube 464 may be co-extruded together. In another suitable example, the inner and middle layer of electrode drainage tube 464 may be co-extruded together and outer layer 484 may be applied in a subsequent step. Electrode drainage tube 464 may also be manufactured by applying the middle and outer layers to a conventional drainage tube. For example, this may be done by wrapping and bonding the middle and outer layers about a conventional drainage tube. The middle and outer layers should be sufficiently flexible to allow the electrode drainage tube be positioned as appropriate to drain excess fluids. In some embodiments, the electrode drainage tube may not include the outer layer. The electrode drainage tube may also be manufactured by assembling two or more hollow cylindrical tubes. One of the tubes may include the electrode and another of the tubes may not include an electrode.
The electrodes shown in medical kit 440 and the other electrodes of the present invention, may include a tether or cord of varying length to attach the electrodes to the control module. In other embodiments, the tether or cord may be separate from the electrodes and may be selected as appropriate for coupling electrodes to a control module.
The foregoing is merely illustrative of the principles of this invention and various modifications can be made by those skilled in the art without departing from the scope and spirit of the invention. For example, the electrodes and methods described herein may be used for applications other than wound healing such as scar reductions, wrinkle reductions, improved quality of tissue deposition, hair growth, and on the face and neck after, for example, dermal peeling following laser or chemical facial peels. In addition, the electrode systems and methods may be used in veterinary applications.
