Use of Remote Ischemic Conditioning on the Treatment of Diabetic Wounds

Introduction: Remote Ischemic Conditioning (RIC) activates the body's natural protective physiology against reperfusion injury and the tissue damage caused by low oxygen levels. More than 10,000 patients have completed trials with RIC over the last two decades and 20,000 more are currently enrolled. Although much research has focused on prevention and post-acute treatment in cardiovascular injury, few trials have focused on the diabetic patient and diabetic ulcers. 

Objective: This case series is early evidence from a proof-of-concept study which aims to show that RIC, delivered with an automated device* is an effective treatment modality for healing diabetic leg and foot ulcers.

Method: Three patients with VLUs and DFUs were given 40-minute treatment sessions of RIC at their home, 3 times per week, over an approximate 12-week period (total of 36 treatments). In addition, all received weekly standard of care. RIC treatment was delivered with an automated pressure cuff that inflates on the bicep to occlude blood flow for four successive 5-minute periods.  

Results: Wounds were reviewed on a weekly basis. In this initial series, all ulcers were 100% epithelialized by the end of the treatment period. The VLU (which had been continually treated for 14-months) closed after 10-weeks. The DFUs were healed after an average of 9.3 weeks. Patients reported improvement in neuropathic symptoms and claimed increased energy. 

Conclusions: RIC treatment was well tolerated by all. Through this series (and the continuing trial) we will show that RIC may be an effective, non-invasive, novel adjunctive approach to treating the diabetic patient. 

*LifeCuff Technologies, Philadelphia, PA