Localized pressure stimulation using turf-like structures can improve skin perfusion in the foot

Objective: Improving perfusion under the skin can potentially reduce ulceration and amputation risk in people with diabetic foot. Localized pressure stimulation has been proven capable of improving skin perfusion in the scalp but its effectiveness for the foot has not been tested. In this study, localized pressure stimulation was realized using flexible turf-like structures (TLS) with dense vertical fibers and their ability to increase perfusion was assessed. Methods: The skin in the rearfoot, midfoot, and forefoot of nine healthy volunteers was stimulated using two TLS with different stiffness and one wound filler material that generated a uniform compression. Changes in perfusion were assessed using laser speckle. Results: Mechanical stimulation significantly increased perfusion in the forefoot and midfoot areas with the TLS achieving higher and more long-lasting increase compared to the wound filler. The stiffer of the two TLS appeared to be the most effective for the forefoot achieving a significant increase in perfusion that lasted for 25.5 seconds immediately after stimulation. Conclusion: The results of this study indicate that localized pressure stimulation is more effective compared to uniform compression for improving skin perfusion in the healthy foot. Further research in people with diabetic foot disease is needed to verify the clinical value of the observed effect.