A Look Back At An Emerging Option For DFUs

A recent open label, single-arm study from Regulski and coworkers continues the data supporting potential use of the safe, simple intervention that is remote ischemic conditioning.1 We have been fascinated with this treatment option for some time, going back to a basic science review I participated in back in 2017.² In this review, we outlined some background on remote ischemic conditioning, along with data current at the time, hopeful that this therapy might have application in a wide variety of settings and treatment algorithms.

As an introduction, remote ischemic conditioning induces short periods (three to five minutes) of limb ischemia using a blood pressure cuff. Originally this technique was directed to protecting cardiac muscle and other organs, but since has undergone study in the diabetic foot. As evidenced by our work, along with that of Regulski and team, there are now any number of manuscripts that strongly suggest that remote ischemic conditioning creates a “distress signal” that upregulates anti-inflammatory and pro-angiogenic factors that may limit ischemic damage and promote healing.

Evidence continues to mount that this treatment option is one worth learning more about.

Dr. Armstrong is Professor of Surgery at the Keck School of Medicine at the University of Southern California. He is the Director of the Southwestern Academic Limb Salvage Alliance (SALSA). 

Editor’s note: This blog originally appeared at: https://diabeticfootonline.com/2021/07/11/impact-of-repeated-remote-ischemic-conditioning-on-diabetic-foot-ulcers/ . It is adapted with permission from the author.

References

1. Regulski M, Greenwood T, Leschinsky B. Impact of repeated remote ischemic conditioning on diabetic foot ulcers: a proof of concept study. Wound Repair Regen. doi: 10.1111/wrr.12956. Online ahead of print. Published July 8, 2021. Accessed August 3, 2021.
2. Boghossian JA, Joseph B, Slepian MJ, Armstrong DG. Remote ischemic conditioning: promising potential in wound repair in diabetes? J Am Podiatr Med Assoc. 2017;107(4):313-317.