title: The effects of intermittent negative pressure on the lower extremities' peripheral circulation and wound healing in four patients with lower limb ischemia and hard-to-heal leg ulcers: a case report.
abstract: Peripheral circulation is severely compromised in the advanced stages of peripheral arterial disease. Recently, it was shown that the application of -40 mmHg intermittent negative pressure (INP) to the lower leg and foot enhances macro- and microcirculation in healthy volunteers. In this case report, we describe the effects of INP treatment on four patients with lower limb ischemia and hard-to-heal leg and foot ulcers. We hypothesized that INP therapy may have beneficial hemodynamic and clinical effects in the patients. Four patients (age range: 61-79 years) with hard-to-heal leg and foot ulcers (6-24 months) and ankle-brachial pressure indices of ≤0.60 on the affected side were included. They were treated with an 8-week intervention period of -40 mmHg INP (10 sec negative pressure and 7 sec atmospheric pressure) on the lower limbs. A custom-made vacuum chamber was used to apply INP to the affected lower leg and foot for 2 h per day. After 8 weeks of INP therapy, one ulcer healed completely, while the other three ulcers were almost completely healed. These cases suggest that INP may facilitate wound healing. The theoretical foundation is that INP assists wound healing by improving blood flow to the small blood vessels in the affected limb, increasing the flow of oxygen and nutrients to the cells.
authors: Section of Vascular Investigations, Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway.|Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.|Otivio AS, Oslo, Norway.
authors: Øyvind H
authors: ØH
authors: Sundby
authors: Section of Vascular Investigations, Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway.|Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
authors: Lars Ø
authors: LØ
authors: Høiseth
authors: Otivio AS, Oslo, Norway.
authors: Iacob
authors: I
authors: Mathiesen
authors: Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.|Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway.
authors: Jørgen J
authors: JJ
authors: Jørgensen
authors: Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway.
authors: Jon O
authors: JO
authors: Sundhagen
authors: Section of Vascular Investigations, Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway jonny.hisdal@medisin.uio.no.
authors: Jonny
authors: J
authors: Hisdal
mesh_terms: D006801:Humans; D007871:Leg Ulcer / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects* / Q000379:methods; D014945:Wound Healing / Q000502:physiology*
keywords: Blood flow; intermittent negative pressure; leg ulcer; peripheral arterial disease; wound healing