Effects of vacuum compression therapy on skin microcirculation in patientssuffering from lower limb ischaemia

Background: We investigated the short-term effect of vacuum compression (VC ) treatment on skin microcirculatory perfusion in the foot of patients with lower limb ischaemia and healthy controls. Patients and Methods: Ten patients with intermittent claudication or rest p ain and 5 healthy controls underwent vacuum-compression treatment for half an hour The leg was positioned in an air-tight plexiglass cylinder in which hypobaric (-115 mm Hg) and hyperbaric (75 mm Hg) pressure could be generat ed alternately, in order to improve peripheral circulation. The effect on s kin microcirculation was investigated using nailfold capillary microscopy ( measuring nutritive perfusion), laser Doppler fluxmetry (LDF) (total skin p erfusion) and transcutaneous oxygen tension measurements (TcpO(2)). Results: A few patients experienced ischaemic symptoms during VC, probably because the leg was pinched off through inflation of the cuff. In both pati ents and controls capillary microscopic parameters did not change significa ntly. In some cases, microcirculatory perfusion decreased because the leg h ad cooled during the treatment. Application of a heating matrass annihilate d this effect. Only in the patient group a few LDF- and TcpO(2) parameters improved slightly, but significantly. Conclusion: Vacuum-compression therapy only slightly improves total skin pe rfusion and oxygenation, but not the nutritive microcirculation, being an e ssential factor in the occurrence of ischaemic symptoms. We therefore concl ude that this instrument in its present form is not an aid in the treatment of lower limb ischaemia.