Cooling the foot to prevent diabetic foot wounds: A proof-of-concept trial

David G Armstrong, Melinda B. Sangalang, David Jolley, Frank Maben, Heather R. Kimbriel, Brent P. Nixon, I. Kelman Cohen

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

The etiology of neuropathic diabetic foot wounds can be summarized by the following formula: pressure x cycles of repetitive stress = ulceration. The final pathway to ulceration consists of an inflammatory response, leading to tissue breakdown. Mitigation of this response might reduce the risk of ulceration. This proof-of-concept trial evaluates whether simple cooling of the foot can safely reduce the time to thermal equilibrium after activity. After a 15-min brisk walk, the six nondiabetic volunteers enrolled were randomly assigned to receive either air cooling or a 10-min 55°F cool water bath followed by air cooling. The process was then repeated with the intervention reversed, allowing subjects to serve as their own controls. There was a rise in mean ± SD skin temperature after 15 min of activity versus preactivity levels (87.8° ± 3.9° versus 79° ± 2.2° F; P= .0001). Water cooling immediately brought the foot to a point cooler than preactivity levels for all subjects, whereas air cooling required an average of nearly 17 min to do so. Ten minutes of cooling required a mean ± SD of 26.2 ± 5.9 min to warm to preactivity levels. No adverse effects resulted from the intervention. We conclude that cooling the foot may be a safe and effective method of reducing inflammation and may serve as a prophylactic or interventional tool to reduce skin breakdown risk.

Original languageEnglish (US)
Pages (from-to)103-107
Number of pages5
JournalJournal of the American Podiatric Medical Association
Volume95
Issue number2
StatePublished - Mar 2005
Externally publishedYes

Fingerprint

Diabetic Foot
Foot
Air
Wounds and Injuries
Skin Temperature
Water
Baths
Volunteers
Hot Temperature
Inflammation
Pressure
Skin

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Armstrong, D. G., Sangalang, M. B., Jolley, D., Maben, F., Kimbriel, H. R., Nixon, B. P., & Cohen, I. K. (2005). Cooling the foot to prevent diabetic foot wounds: A proof-of-concept trial. Journal of the American Podiatric Medical Association, 95(2), 103-107.

Cooling the foot to prevent diabetic foot wounds : A proof-of-concept trial. / Armstrong, David G; Sangalang, Melinda B.; Jolley, David; Maben, Frank; Kimbriel, Heather R.; Nixon, Brent P.; Cohen, I. Kelman.

In: Journal of the American Podiatric Medical Association, Vol. 95, No. 2, 03.2005, p. 103-107.

Research output: Contribution to journalArticle

Armstrong, DG, Sangalang, MB, Jolley, D, Maben, F, Kimbriel, HR, Nixon, BP & Cohen, IK 2005, 'Cooling the foot to prevent diabetic foot wounds: A proof-of-concept trial', Journal of the American Podiatric Medical Association, vol. 95, no. 2, pp. 103-107.
Armstrong, David G ; Sangalang, Melinda B. ; Jolley, David ; Maben, Frank ; Kimbriel, Heather R. ; Nixon, Brent P. ; Cohen, I. Kelman. / Cooling the foot to prevent diabetic foot wounds : A proof-of-concept trial. In: Journal of the American Podiatric Medical Association. 2005 ; Vol. 95, No. 2. pp. 103-107.
@article{4d106558e6884c418f828a216959be75,
title = "Cooling the foot to prevent diabetic foot wounds: A proof-of-concept trial",
abstract = "The etiology of neuropathic diabetic foot wounds can be summarized by the following formula: pressure x cycles of repetitive stress = ulceration. The final pathway to ulceration consists of an inflammatory response, leading to tissue breakdown. Mitigation of this response might reduce the risk of ulceration. This proof-of-concept trial evaluates whether simple cooling of the foot can safely reduce the time to thermal equilibrium after activity. After a 15-min brisk walk, the six nondiabetic volunteers enrolled were randomly assigned to receive either air cooling or a 10-min 55°F cool water bath followed by air cooling. The process was then repeated with the intervention reversed, allowing subjects to serve as their own controls. There was a rise in mean ± SD skin temperature after 15 min of activity versus preactivity levels (87.8° ± 3.9° versus 79° ± 2.2° F; P= .0001). Water cooling immediately brought the foot to a point cooler than preactivity levels for all subjects, whereas air cooling required an average of nearly 17 min to do so. Ten minutes of cooling required a mean ± SD of 26.2 ± 5.9 min to warm to preactivity levels. No adverse effects resulted from the intervention. We conclude that cooling the foot may be a safe and effective method of reducing inflammation and may serve as a prophylactic or interventional tool to reduce skin breakdown risk.",
author = "Armstrong, {David G} and Sangalang, {Melinda B.} and David Jolley and Frank Maben and Kimbriel, {Heather R.} and Nixon, {Brent P.} and Cohen, {I. Kelman}",
year = "2005",
month = "3",
language = "English (US)",
volume = "95",
pages = "103--107",
journal = "Journal of the American Podiatric Medical Association",
issn = "8750-7315",
publisher = "American Podiatric Medical Association",
number = "2",

}

TY - JOUR

T1 - Cooling the foot to prevent diabetic foot wounds

T2 - A proof-of-concept trial

AU - Armstrong, David G

AU - Sangalang, Melinda B.

AU - Jolley, David

AU - Maben, Frank

AU - Kimbriel, Heather R.

AU - Nixon, Brent P.

AU - Cohen, I. Kelman

PY - 2005/3

Y1 - 2005/3

N2 - The etiology of neuropathic diabetic foot wounds can be summarized by the following formula: pressure x cycles of repetitive stress = ulceration. The final pathway to ulceration consists of an inflammatory response, leading to tissue breakdown. Mitigation of this response might reduce the risk of ulceration. This proof-of-concept trial evaluates whether simple cooling of the foot can safely reduce the time to thermal equilibrium after activity. After a 15-min brisk walk, the six nondiabetic volunteers enrolled were randomly assigned to receive either air cooling or a 10-min 55°F cool water bath followed by air cooling. The process was then repeated with the intervention reversed, allowing subjects to serve as their own controls. There was a rise in mean ± SD skin temperature after 15 min of activity versus preactivity levels (87.8° ± 3.9° versus 79° ± 2.2° F; P= .0001). Water cooling immediately brought the foot to a point cooler than preactivity levels for all subjects, whereas air cooling required an average of nearly 17 min to do so. Ten minutes of cooling required a mean ± SD of 26.2 ± 5.9 min to warm to preactivity levels. No adverse effects resulted from the intervention. We conclude that cooling the foot may be a safe and effective method of reducing inflammation and may serve as a prophylactic or interventional tool to reduce skin breakdown risk.

AB - The etiology of neuropathic diabetic foot wounds can be summarized by the following formula: pressure x cycles of repetitive stress = ulceration. The final pathway to ulceration consists of an inflammatory response, leading to tissue breakdown. Mitigation of this response might reduce the risk of ulceration. This proof-of-concept trial evaluates whether simple cooling of the foot can safely reduce the time to thermal equilibrium after activity. After a 15-min brisk walk, the six nondiabetic volunteers enrolled were randomly assigned to receive either air cooling or a 10-min 55°F cool water bath followed by air cooling. The process was then repeated with the intervention reversed, allowing subjects to serve as their own controls. There was a rise in mean ± SD skin temperature after 15 min of activity versus preactivity levels (87.8° ± 3.9° versus 79° ± 2.2° F; P= .0001). Water cooling immediately brought the foot to a point cooler than preactivity levels for all subjects, whereas air cooling required an average of nearly 17 min to do so. Ten minutes of cooling required a mean ± SD of 26.2 ± 5.9 min to warm to preactivity levels. No adverse effects resulted from the intervention. We conclude that cooling the foot may be a safe and effective method of reducing inflammation and may serve as a prophylactic or interventional tool to reduce skin breakdown risk.

UR - http://www.scopus.com/inward/record.url?scp=17144386196&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=17144386196&partnerID=8YFLogxK

M3 - Article

C2 - 15778466

AN - SCOPUS:17144386196

VL - 95

SP - 103

EP - 107

JO - Journal of the American Podiatric Medical Association

JF - Journal of the American Podiatric Medical Association

SN - 8750-7315

IS - 2

ER -