TY - JOUR
T1 - Effectiveness of Lower-Extremity Electrical Stimulation to Improve Skin Perfusion
AU - Zulbaran-Rojas, Alejandro
AU - Park, Catherine
AU - Lepow, Brian
AU - Najafi, Bijan
N1 - Funding Information:
Acknowledgment: Naima Rodriguez, Hector Eliz-ondo, Anmol Momin, and Sogol Golafshan for assisting with data collection and coordination of this research study between involved key investigators. Financial Disclosure: This study was supported in part by a grant from Avazzia Inc (Dallas, Texas). Conflict of Interest: None reported.
Publisher Copyright:
© 2021, American Podiatric Medical Association. All rights reserved.
PY - 2021/11
Y1 - 2021/11
N2 - Background: Although numerous studies suggest the benefit of electrical stimulation (E-Stim) therapy to accelerate wound healing, the underlying mechanism of action is still debated. In this pilot study, we examined the potential effectiveness of lower-extremity E-Stim therapy to improve tissue perfusion in patients with diabetic foot ulcers. Methods: Thirty-eight patients with diabetic foot ulcers underwent 60 min of active E-Stim therapy on acupuncture points above the level of the ankle joint using a bioelectric stimulation technology platform. Perfusion changes in response to E-Stim were assessed by measuring skin perfusion pressure (SPP) at baseline and during 30 and 60 min of therapy; retention was assessed 10 min after therapy. Tissue oxygen saturation (SatO2) was measured using a noninvasive near-infrared camera. Results: Skin perfusion pressure increased in response to E-Stim therapy (P ¼ .02), with maximum improvement observed at 60 min (11%; P ¼ .007) compared with baseline; SPP reduced 10 min after therapy but remained higher than baseline (9%; P ¼ .1). Magnitude of improvement at 60 min was negatively correlated with baseline SPP values (r ¼ –0.45; P ¼ .01), suggesting that those with lower perfusion could benefit more from E-Stim therapy. Similar trends were observed for SatO2, with statistically significant improvement for a subsample (n ¼ 16) with moderate-to-severe peripheral artery disease. Conclusions: This study provides early results on the feasibility and effectiveness of E-Stim therapy to improve skin perfusion and SatO2. The magnitude of benefit is higher in those with poorer skin perfusion. Also, the effects of E-Stim could be washed out after stopping therapy, and regular daily application might be required for effective benefit in wound healing. (J Am Podiatr Med Assoc 111(6): 1-11, 2021).
AB - Background: Although numerous studies suggest the benefit of electrical stimulation (E-Stim) therapy to accelerate wound healing, the underlying mechanism of action is still debated. In this pilot study, we examined the potential effectiveness of lower-extremity E-Stim therapy to improve tissue perfusion in patients with diabetic foot ulcers. Methods: Thirty-eight patients with diabetic foot ulcers underwent 60 min of active E-Stim therapy on acupuncture points above the level of the ankle joint using a bioelectric stimulation technology platform. Perfusion changes in response to E-Stim were assessed by measuring skin perfusion pressure (SPP) at baseline and during 30 and 60 min of therapy; retention was assessed 10 min after therapy. Tissue oxygen saturation (SatO2) was measured using a noninvasive near-infrared camera. Results: Skin perfusion pressure increased in response to E-Stim therapy (P ¼ .02), with maximum improvement observed at 60 min (11%; P ¼ .007) compared with baseline; SPP reduced 10 min after therapy but remained higher than baseline (9%; P ¼ .1). Magnitude of improvement at 60 min was negatively correlated with baseline SPP values (r ¼ –0.45; P ¼ .01), suggesting that those with lower perfusion could benefit more from E-Stim therapy. Similar trends were observed for SatO2, with statistically significant improvement for a subsample (n ¼ 16) with moderate-to-severe peripheral artery disease. Conclusions: This study provides early results on the feasibility and effectiveness of E-Stim therapy to improve skin perfusion and SatO2. The magnitude of benefit is higher in those with poorer skin perfusion. Also, the effects of E-Stim could be washed out after stopping therapy, and regular daily application might be required for effective benefit in wound healing. (J Am Podiatr Med Assoc 111(6): 1-11, 2021).
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U2 - 10.7547/20-172
DO - 10.7547/20-172
M3 - Article
AN - SCOPUS:85111932290
SN - 8750-7315
VL - 111
SP - 1
EP - 11
JO - Journal of the American Podiatric Medical Association
JF - Journal of the American Podiatric Medical Association
IS - 6
ER -