| Diabetic lower extremity ischemia (DLEI) causes approximately 90,000 leg amputations each year in the United States (Baser, Verpillat, Gabriel & Wang 2013). A review of the literature revealed that sufficient evidence exists to consider using pulsed electromagnetic field (PEMF) therapy as a non-invasive curative modality that could prevent many of these amputations. However, the staggering number of leg amputations following lengthy episodes of ischemic deterioration suggests a lack of consensus as to the efficacy of PEMF (Mulder, Tenenhaus & D'Souza, 2014). Therefore, the purpose of this study is to provide an evidentiary basis for using PEMF therapy in a primary care setting to promote microvascular angiogenesis and thereby prevent skin ulceration. In this study, 7 people between the ages 54 and 65 who have diabetes mellitus type 2 and some level DLEI underwent 10 to 22 treatments with a DiapulseRTM PEMF device. Each participant as tested for microvascular red blood cell (RBC) perfusion (Q), volume concentration of moving RBCs (V), RBC speed (U) and temperature (T) in the plantar skin. These parameters were measured using a laser Doppler flowmeter before and after the course of treatment. The Wilcoxon Signed Rank Test showed significant increases in V and decreases in U (p = 0.018 for both) with Q being slightly above the significance level at p = 0.063. These findings are consistent with those found in the literature. Therefore, the use of PEMF for treating chronic wounds should be considered for inclusion in standard Advanced Practice Registered Nursing (APRN) guidelines for evidenced-based practice. However, justifying the use of PEMF to prevent diabetic ulcers requires further study. |
