A “vacuum boot” that sucks blood down to the lower leg and foot could have potential as treatment for patients with severely reduced blood flow to the feet, according to Øyvind Heiberg Sundby’s PhD thesis.
MAIN RESULTS:
- A new system that generates oscillation pressure within a boot increases blood flow to the feet of healthy volunteers.
- The boot also increases blood flow to the lower limb of patients with peripheral artery disease, and could potentially heal severe ulcers.
- Also patients with spinal cord injury could benefit from treatment with the “vacuum boot”.
THESIS DEFENCE:
Thesis: The effects of lower limb intermittent negative pressure on foot circulation and wound healing – Experimental and prospective studies exploring the acute circulatory and clinical effects of intermittent mild ambient subatmospheric pressure to the lower leg and foot
Candidate: Øyvind Heiberg Sundby
Time: March 22, 2018 at 13:15
Place: Oslo University Hospital Aker: Kirurgisk auditorium
Link to university website (in Norwegian)
SUMMARY:
(1) The FlowOx™ system draws blood down into the leg by generating oscillation pressure inside a boot. In 25 healthy volunteers, blood flow to the lower leg and foot increased following experiments with intermittent negative pressure. During constant negative pressure, the blood flow decreased compared to no pressure.
(2) Hard-to-heal ulcers healed completely or almost completely in four patients with lower limb ischemia following eight weeks treatment with intermittent negative pressure. All four patients had recieved standard treatment for ulcers for at least five months prior to the study.
(3) Only ten minutes with the leg in the vacuum chamber increased blood flow in 20 patients with peripheral artery disease. Both blood flow to the skin and large arteries in the foot increased when the negative pressure was applied, and the effect lasted for at least five minutes after the treatment.
(4/5) Also patients with spinal cord injury experienced improved blood flow to the lower legs following treatment with intermittent negative pressure. In a randomized crossover study including nine patients, Sundby and coworkers also show that the system can be used as home-based treatment for ulcers, but larger studies are needed to evaluate the efficacy compared to standard care.
REFERENCES:
(1) Sundby, Ø. H., Høiseth, L. Ø., Mathiesen, I., Jørgensen, J. J., Weedon‐Fekjær, H., & Hisdal, J. (2016). Application of intermittent negative pressure on the lower extremity and its effect on macro‐and microcirculation in the foot of healthy volunteers. Physiological reports, 4(17), e12911.
(2) Sundby, Ø. H., Høiseth, L. Ø., Mathiesen, I., Jørgensen, J. J., Sundhagen, J. O., & Hisdal, J. (2016). 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. Physiological reports, 4(20), e12998.
(3) Sundby, Ø. H., Høiseth, L. Ø., Mathiesen, I., Weedon-Fekjær, H., Sundhagen, J. O., & Hisdal, J. (2017). The acute effects of lower limb intermittent negative pressure on foot macro-and microcirculation in patients with peripheral arterial disease. PloS one, 12(6), e0179001.
(4) Sundby, Ø. H., Høiseth, L. Ø., Irgens, I., Mathiesen, I., Lundgaard, E., Haugland, H., Weedon-Fekjær, H., Sundhagen, J. O., Sandbæk, G., & Hisdal, J. (2017). Intermittent negative pressure applied to the lower limb increases foot macrocirculatory and microcirculatory blood flow pulsatility in people with spinal cord injury. Spinal cord, 1.
(5) Sundby, Ø. H., Irgens, I., Høiseth, L. Ø., Mathiesen, I., Lundgaard, E., Haugland, H., Weedon-Fekjær, H., Sundhagen, J. O., Sandbæk, G., & Hisdal, J. (2018). Intermittent mild negative pressure applied to the lower limb in patients with spinal cord injury and chronic lower limb ulcers: a crossover pilot study. Spinal cord, 1.
