Cooling the foot to prevent diabetic foot wounds: A proof-of-concept trial

David G. Armstrong, Melinda B. Sangalang, David Jolley, Frank Maben, Heather R. Kimbriel, Brent P. Nixon, I. Kelman Cohen

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


The etiology of neuropathic diabetic foot wounds can be summarized by the following formula: pressure x cycles of repetitive stress = ulceration. The final pathway to ulceration consists of an inflammatory response, leading to tissue breakdown. Mitigation of this response might reduce the risk of ulceration. This proof-of-concept trial evaluates whether simple cooling of the foot can safely reduce the time to thermal equilibrium after activity. After a 15-min brisk walk, the six nondiabetic volunteers enrolled were randomly assigned to receive either air cooling or a 10-min 55°F cool water bath followed by air cooling. The process was then repeated with the intervention reversed, allowing subjects to serve as their own controls. There was a rise in mean ± SD skin temperature after 15 min of activity versus preactivity levels (87.8° ± 3.9° versus 79° ± 2.2° F; P= .0001). Water cooling immediately brought the foot to a point cooler than preactivity levels for all subjects, whereas air cooling required an average of nearly 17 min to do so. Ten minutes of cooling required a mean ± SD of 26.2 ± 5.9 min to warm to preactivity levels. No adverse effects resulted from the intervention. We conclude that cooling the foot may be a safe and effective method of reducing inflammation and may serve as a prophylactic or interventional tool to reduce skin breakdown risk.

Original languageEnglish (US)
Pages (from-to)103-107
Number of pages5
JournalJournal of the American Podiatric Medical Association
Issue number2
StatePublished - 2005
Externally publishedYes

ASJC Scopus subject areas

  • Podiatry
  • Orthopedics and Sports Medicine


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