Information for Physicians.
The Circulator Boot (CB)

The Circulator Boot (CB) is a noninvasive devise used to treat non-healing lower extremity wounds. It is a modified compression therapy, effective in improving blood flow and healing of ischemic ulcers offered in supervised healthcare setting. It incorporates cardiac monitor so that pneumatic compressions can be delivered to the end diastolic portion of the heart rhythm to improve arterial blood flow and heal ischemic ulcers. The therapy is not limited to patients with peripheral arterial occlusive disease (PAD), but successful outcomes can be achieved in patients with severe PAD who have no option for revascularization or endovascular intervention. The typical treatment lasts 40-45 min. The patient may require 35 treatments for complete cure or improvement. The system can also be used with the extremity immersed in a sea soak solution to enhance debridment.
Diabetes mellitus (DM) in on the rise. Latest statistics estimate 18.4 million individuals have DM, most of them type 2. In year 2001 CDC reported over 80,000 leg amputations, with a trend to increase every year in spite of the progress in treating leg wounds. Every year, 7 or 8 of every 1000 American~ who have diabetes undergo amputation of foot. Twice as high in African Americans and higher in Hispanics and Native Americans. Rates increase with age and duration of the disease. (Postgrad Med July 1999). Foot infections account for 25% of all hospital admissions of diabetic patients. When foot ulcers develop one in five of these patients undergo amputation.
Peripheral arterial disease (PAD) In US 8.4 million individuals suffer from PAD. Prevalence of disease in US is increasing with age. At age 40-59--3% individuals have PAD, at age 60-69--8% and over age 70--19%. Although less common, critical leg ischemia (CLI) may affect as many as 500,000 to 1,000,000 individuals each year. As a group, these patients may have a high risk of cardiovascular morbidity and mortality. In patients with CLI, the risk of mortality can be as high as 25% per year. PAD can be considered a marker for diffuse systemic atherosclerosis, panvascular disease, including cardiovascular ischemic disease and cerebral atherosclerosis. 50% of patients with intermittent claudication (IC) within 5 years are stable or improve, 16% have a progression of disease and 25% will require surgery and experience loss of tissue. (www.AdvancePCS.co11l) - Identifying and Treating Symptoms of Intermittent Claudication. Patients with diabetes mellitus develop PAD at accelerated rates. Women with diabetes do not have protection against atherosclerosis before menopause as compared to a healthy group, who are protected.

(*Please note that: " The Bryn Mawr Wound Care Center" is not to be confused with the Bryn Mawr Hospital or The Wound Healing Center at the Bryn Mawr Hospital. "The Bryn Mawr Wound Care Center" is a different entity and is not part of the Bryn Mawr Hospital.")