Impact Of Extracorporeal Shock Wave Therapy On Microcirculation In Diabetic Feet: A Pilot Study
Seung Kyu Han, Jae youn Kim,, Ji Won Son, Sik Namgoong.
Korea University Guro Hospital, seoul, Korea, Republic of.
OBJECTIVE: Patients with diabetic foot commonly experience vascular insufficiency and compromised tissue perfusion. Extracorporeal shockwave therapy (ESWT) reportedly promotes wound healing and angiogenesis. However, clinical studies on the effect of ESWT on angiogenesis are scarce and the exact mechanism of ESWT remains unclear. This study investigated the effect of ESWT on cutaneous microcirculation in diabetic feet. METHODS: Ten patients with diabetic feet received ESWT twice weekly for a total of six sessions. Transcutaneous partial oxygen pressure (TcPO2) and cutaneous blood flow were measured before and after ESWT. MAIN RESULTS: The treated feet had significant improvement in mean TcPO2 (P < 0.01) and cutaneous blood flow (P < 0.05) level compared to that of the control feet respectively. On the treated feet, the TcPO2 increased from 41.4±9.9 to 49.5±8.7 mmHg after therapy, an increase of 19.6%. In the opposite (control) feet, the TcPO2 decreased from 39.5±14.0 mmHg to 34.9±14.5 mmHg, a decrease of 11.6%. The average cutaneous blood flow level on the treated feet before ESWT was 36.9±25.6 and increased to 48.3±32.4 AU after ESWT, an increase of 30.9%. In the control feet, the cutaneous blood flow level decreased from 80.5±36.7 to 60.4±38.8 AU after ESWT, a decrease of 25.0%. CONCLUSION: These results demonstrate that ESWT may have beneficial effects on microcirculation in diabetic feet. KEYWORDS: Diabetic feet, Extracorporeal shockwave therapy, Microcirculation
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