Insulated Offloading Provides Offloading Protection and Enhanced Skin Perfusion.
Charles A Andersen1, Mario Ponticello1, Nicole Byerley1
1Madigan Army Medical Center, Tacoma, WA.
Wounds : a Compendium of Clinical Research and Practice
|September 14, 2018
Summary
Insulated offloading boots and mitts increase local skin warmth and blood flow in extremities with compromised circulation. This enhanced cutaneous perfusion may aid wound healing and recovery in affected areas.
Area of Science:
- Biomedical Engineering
- Vascular Physiology
- Wound Care Technology
Background:
- Local and systemic heat stress induce vasodilation, increasing cutaneous blood flow.
- Increased peripheral circulation may benefit extremities with wounds or compromised arterial supply.
- External insulation can potentially enhance local cutaneous perfusion.
Purpose of the Study:
- To evaluate if insulated offloading boots/mitts increase local cutaneous perfusion.
- To assess the impact of insulated offloading devices on extremity blood flow using indocyanine green fluorescence angiography (ICGFA).
Main Methods:
- Nine patients with extremity wounds/compromised arterial supply were studied.
- Indocyanine green fluorescence angiography (ICGFA) was used to measure cutaneous perfusion.
- Measurements were taken before and after a 60-minute use of insulated offloading boots/mitts.
Main Results:
- Patients experienced a mean local skin warming of 3.1ºF.
- Local cutaneous perfusion increased, with significant changes in ingress and egress rates.
- ICGFA confirmed preferential shunting of blood flow to areas of greatest need.
Conclusions:
- Insulated offloading boot or mitt use enhances local skin perfusion.
- This improved perfusion may offer an additional benefit for wound healing and extremity care.
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