Impact of repeated remote ischemic conditioning on diabetic foot ulcers

This open label, single-arm study from Regulski and coworkers continues the data supporting potential use of this safe, simple intervention

Patients with a diabetic foot ulcer (DFU) suffer disabilities and are at increased riskfor lower extremity amputation. Current standard of care includes debridement, topi-cal antibiotics, and weight off-loading—still resulting in low rates of healing. Previoussmall-scale research has indicated that repeated remote ischemic conditioning (rRIC)is a novel modality that delivers significantly higher DFU healing rates. This proof-of-concept study was performed to expand the research on the utility of rRIC as anadjunctive treatment in the healing of chronic DFUs. Forty subjects (41 wounds)received rRIC treatment three times weekly in addition to standard of care for12 weeks. Subjects that did not heal in this time frame but had a significant reductionin wound size were eligible to continue for an 8-week extension period. By the endof the extension period, 31 of the 41 DFU wounds (75.6%) in this study were deter-mined to be healed. This compares favourably to the 25–30% standard of care aver-age healing rate. For additional comparison, another group of patients receivingstandard of care alone, by the same investigator, was selected and matched bywound size at baseline and wound location. For this matching cohort, after 20 weeksof treatment, only 15 of the 41 DFU comparison wounds (36.6%) were determinedto be healed, in line with other standard of care results. In the rRIC treatment group,the 10 wounds that did not heal, experienced an average reduction in wound area of54.3%. The results of this proof-of-concept study reinforce earlier evidence that theaddition of rRIC to local wound care significantly improves the healing of chronic dia-betic foot ulcers.

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