Jeong et al. 2023
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Jeong D, Lee JH, Lee GB, Shin KH, Hwang J, Jang SY, Yoo J, Jang WY. Application of extracorporeal shockwave therapy to improve microcirculation in diabetic foot ulcers: A prospective study. Medicine (Baltimore). 2023 Mar 17;102(11):e33310..
Design: Prospective Study Subjects: 25 patients (50 feet) with Wagner grade I to II DFU in this study. Methods: The affected feet of patients were used as the ESWT group (n=32) and the unaffected contralateral feet were used as the control group (n=18). ESWT was performed in 3 sessions per week for a total of 3 weeks. Each patient received 9 sessions over the course of 3 weeks. Each foot received 1500 impulses at an energy flux density of 0.2 mJ/mm2 with a frequency of 4 Hz. Outcomes included: Transcutaneous partial oxygen pressure (TcPO2) tissue microcirculation in the feet before and after ESWT. Based on a previous study, the optimal cutoff level of TcPO2 was set to 43 mmHg, and the odds ratio was 4.4. Results: • The TcPO2 level in the ESWT group was recovered by the 2nd week of treatment (>43 mmHg) (P < .05 compared to baseline). • In the control group, no significant differences from baseline were found (P>.05) • In subgroup comparisons (Wagner grade I vs. Wagner grade II), no significantly differences were found for serial changes in TcPO2 levels across the 3 weeks. • A period of ESWT application of at least 2 weeks or more than 6 sessions may be considered for the treatment of DFU with Wagner grades I and II.
Key message: ESWT significantly increased microcirculation in DFU and could be beneficial for the treatment of DFU if applied for at least 2 weeks or more than 6 sessions.
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