Defocused Shock Wave Therapy for Chronic Wounds

Inclusion Criteria: * chronic post-traumatic, venous, arterial, diabetic, or mixed wound of the lower limb * wound persisting for longer than three months * a wound surface bigger than 0,5 cm2 * a wound diameter between 0.5 and 5 cm * unresponsiveness to conservative treatments and advanced wound managements in the 3 months prior to enrollment * no changes in wound managements during the study. Exclusion Criteria: * an ankle brachial index (ABPI)\<0.7 and TcPO2\<40 mmHg * arrhythmias, presence of pacemaker, or coagulation disorders * use of anticoagulant drugs * neoplasia * pregnancy * soft tissue wound infections and/or osteomyelitis * patients with full-thickness loss of soft tissue and extension into muscle, bone, tendon, or joint capsule.