The Assessment of Buerger's Exercise on Dorsal Foot Skin Circulation in Patients with Vasculopathic Diabetic Foot Ulcer by Using Wireless Near-infrared Spectroscope: a Cohort Prospective Study

Overview

Journal Lasers Med Sci

Publisher Springer

Date 2018 Jan 9

PMID 29308553

Citations 6

Authors

Bor-Shyh Lin

Chang-Cheng Chang

Chun-Lin Su

Jhe-Ruei Li

Min-Ling Chen

Mei-Yen Chen

Yao-Kuang Huang

Affiliations

Soon will be listed here.

Abstract

The improvement of peripheral circulation is crucial for the care of vasculopathic diabetic foot ulcer (DFU). Near-infrared spectroscopy (NIRS) was used to investigate the effects of Buerger's exercise on dorsal foot skin circulation with novel technique of measuring the absorption difference in wavelength of light between oxy-hemoglobin (HbO) and deoxy-hemoglobin (HbR). Patients with vasculopathic DFU who could tolerate Buerger's exercise three times a day at home for at least 8 weeks were enrolled (group A). They were divided into two subgroups: without previous percutaneous transluminal angioplasty (PTA) (group A1) vs. with previous PTA (group A2). Wireless NIRS were applied on patients' dorsal foot to assess the peripheral circulation in follow-up clinics. The patients' wound condition, follow-up time, and concentration of HbO and total hemoglobin (HbT) before and after exercise rehabilitation program were documented. From May 2015 to February 2016, 14 patients with average age of 70.2 ± 11.2 were enrolled in this study (group A), including eight without previous PTA (group A1), and six with previous PTA (group A2). The concentration of HbO2 and HbT were significantly increased after exercise rehabilitation program training in group A (p = 0.024 in HbO, p = 0.02 in HbT, n = 14) and group A2 (p = 0.021 in HbO, p = 0.028 in HbT, n = 6), while the concentration in group A1 were improved with borderline significance after exercise (p = 0.055 in HbO, p = 0.058 in HbT, n = 8). The majority of the ulcers were either completely healed (11/14 = 78.57%) or improving (3/14 = 21.43%). Buerger's exercise improved the peripheral circulation and wound condition in patients with vasculopathic DFU. The wireless apparatus is a novel and efficient tool to monitor rehabilitation program.

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References

Chen Y, Shen Z, Shao Z, Yu P, Wu J . Free Flap Monitoring Using Near-Infrared Spectroscopy: A Systemic Review. Ann Plast Surg. 2015; 76(5):590-7. DOI: 10.1097/SAP.0000000000000430. View

Joshi B, Ono M, Brown C, Brady K, Easley R, Yenokyan G . Predicting the limits of cerebral autoregulation during cardiopulmonary bypass. Anesth Analg. 2011; 114(3):503-10. PMC: 3288415. DOI: 10.1213/ANE.0b013e31823d292a. View

Reiber G, Vileikyte L, Boyko E, Del Aguila M, Smith D, Lavery L . Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. Diabetes Care. 1999; 22(1):157-62. DOI: 10.2337/diacare.22.1.157. View

Pennekamp C, Bots M, Kappelle L, Moll F, de Borst G . The value of near-infrared spectroscopy measured cerebral oximetry during carotid endarterectomy in perioperative stroke prevention. A review. Eur J Vasc Endovasc Surg. 2009; 38(5):539-45. DOI: 10.1016/j.ejvs.2009.07.008. View

Met R, Bipat S, Legemate D, Reekers J, Koelemay M . Diagnostic performance of computed tomography angiography in peripheral arterial disease: a systematic review and meta-analysis. JAMA. 2009; 301(4):415-24. DOI: 10.1001/jama.301.4.415. View

Potier L, Abi Khalil C, Mohammedi K, Roussel R . Use and utility of ankle brachial index in patients with diabetes. Eur J Vasc Endovasc Surg. 2010; 41(1):110-6. DOI: 10.1016/j.ejvs.2010.09.020. View

Jeffcoate W, Harding K . Diabetic foot ulcers. Lancet. 2003; 361(9368):1545-51. DOI: 10.1016/S0140-6736(03)13169-8. View

Singh N, Armstrong D, Lipsky B . Preventing foot ulcers in patients with diabetes. JAMA. 2005; 293(2):217-28. DOI: 10.1001/jama.293.2.217. View

Di Stasi C, Di Gregorio F, Cina A, Pedicelli A, Cotroneo A . The diabetic foot: role of color-Doppler US. Rays. 1998; 22(4):562-78. View

10.

Hauser C, Klein S, Mehringer C, Appel P, Shoemaker W . Superiority of transcutaneous oximetry in noninvasive vascular diagnosis in patients with diabetes. Arch Surg. 1984; 119(6):690-4. DOI: 10.1001/archsurg.1984.01390180054009. View

11.

Pecoraro R, Reiber G, BURGESS E . Pathways to diabetic limb amputation. Basis for prevention. Diabetes Care. 1990; 13(5):513-21. DOI: 10.2337/diacare.13.5.513. View

12.

Repez A, Oroszy D, Arnez Z . Continuous postoperative monitoring of cutaneous free flaps using near infrared spectroscopy. J Plast Reconstr Aesthet Surg. 2007; 61(1):71-7. DOI: 10.1016/j.bjps.2007.04.003. View

13.

Faglia E, Dalla Paola L, Clerici G, Clerissi J, Graziani L, Fusaro M . Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003. Eur J Vasc Endovasc Surg. 2005; 29(6):620-7. DOI: 10.1016/j.ejvs.2005.02.035. View

14.

Madsen P, Secher N . Near-infrared oximetry of the brain. Prog Neurobiol. 1999; 58(6):541-60. DOI: 10.1016/s0301-0082(98)00093-8. View

15.

Boezeman R, Moll F, Unlu C, de Vries J . Systematic review of clinical applications of monitoring muscle tissue oxygenation with near-infrared spectroscopy in vascular disease. Microvasc Res. 2015; 104:11-22. DOI: 10.1016/j.mvr.2015.11.004. View

16.

Chen M, Lin B, Su C, Lin Y, Chen M, Shen J . The application of wireless near infrared spectroscopy on detecting peripheral circulation in patients with diabetes foot ulcer when doing Buerger's exercise. Lasers Surg Med. 2017; 49(7):652-657. DOI: 10.1002/lsm.22667. View

17.

Yazdanpanah L, Nasiri M, Adarvishi S . Literature review on the management of diabetic foot ulcer. World J Diabetes. 2015; 6(1):37-53. PMC: 4317316. DOI: 10.4239/wjd.v6.i1.37. View

18.

Yamada T, Ohta T, Ishibashi H, Sugimoto I, Iwata H, Takahashi M . Clinical reliability and utility of skin perfusion pressure measurement in ischemic limbs--comparison with other noninvasive diagnostic methods. J Vasc Surg. 2008; 47(2):318-23. DOI: 10.1016/j.jvs.2007.10.045. View