Bloom DE, Cafiero ET, Jané-Llopis E, et al: The Global Economic Burden of Noncommunicable Diseases, World Economic Forum, Geneva, 2011.
Centers for Disease Control and Prevention: National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. US Department of Health and Human Services, Atlanta, GA, 2014.
Singh N, Armstrong DG, Lipsky BA: Preventing foot ulcers in patients with diabetes. JAMA 293: 217, 2005.
Bus SA, van Netten JJ, Lavery LA, et al: IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev 32(suppl 1): 16, 2016.
Shaked G, Czeiger D, Abu Arar A, et al: Intermittent cycles of remote ischemic preconditioning augment diabetic foot ulcer healing. Wound Repair Regen 23: 191, 2015.
Lim SH, Hausenloy DJ: Remote ischemic conditioning: from bench to bedside. Front Physiol 3: 27, 2012.
Lavery LA, Peters EJ, Armstrong DG: What are the most effective interventions in preventing diabetic foot ulcers? Int Wound J 5: 425, 2008.
Armstrong DG, Lavery LA, Nixon BP, et al: It is not what you put on, but what you take off: techniques for debriding and offloading the diabetic foot wound. Clin Infect Dis 39: S92, 2004.
Murry CE, Jennings RB, Reimer KA: Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation 74: 1124, 1986.
Joseph B, Pandit V, Zangbar B, et al: Secondary brain injury in trauma patients: the effects of remote ischemic conditioning. J Trauma Acute Care Surg 78: 698, 2015.
Kharbanda RK, Mortensen UM, White PA, et al: Transient limb ischemia induces remote ischemic preconditioning in vivo. Circulation 106: 2881, 2002.
McClanahan TB, Nao BS, Wolke LJ, et al: Brief renal occlusion and reperfusion reduces myocardial infarct size in rabbits. FASEB J 7: A118, 1993.
Gho BC, Schoemaker RG, Van Den Doel MA, et al: Myocardial protection by brief ischemia in noncardiac tissue. Circulation 94: 2193, 1996.
Birnbaum Y, Hale SL, Kloner RA: Ischemic preconditioning at a distance: reduction of myocardial infarct size by partial reduction of blood supply combined with rapid stimulation of the gastrocnemius muscle in the rabbit. Circulation 96: 1641, 1997.
Oxman T, Arad M, Klein R, et al: Limb ischemia preconditions the heart against reperfusion tachyarrhythmia. Am J Physiol 273: H1707, 1997.
Tapuria N, Kumar Y, Habib MM, et al: Remote ischemic preconditioning: a novel protective method from ischemia reperfusion injury: a review. J Surg Res 150: 304, 2008.
Saxena P, Newman MA, Shehatha JS, et al: Remote ischemic conditioning: evolution of the concept, mechanisms, and clinical application. J Card Surg 25: 127, 2010.
Joseph B, Khalil M, Hashmi A, et al: Survival benefits of remote ischemic conditioning in sepsis. J Surg Res 213: 131, 2017.
Konstantinov IE, Arab S, Kharbanda RK, et al: The remote ischemic preconditioning stimulus modifies inflammatory gene expression in humans. Physiol Genomics 19: 143, 2004.
Kharbanda RK, Peters M, Walton B, et al: Ischemic preconditioning prevents endothelial injury and systemic neutrophil activation during ischemia-reperfusion in humans in vivo. Circulation 103: 1624, 2001.
Przyklenk K, Bauer B, Ovize M, et al: Regional ischemic ‘preconditioning' protects remote virgin myocardium from subsequent sustained coronary occlusion. Circulation 87: 893, 1993.
Kanoria S, Jalan R, Seifalian AM, et al: Protocols and mechanisms for remote ischemic preconditioning: a novel method for reducing ischemia reperfusion injury. Transplantation 84: 445, 2007.
Jensen HA, Loukogeorgakis S, Yannopoulos F, et al: Remote ischemic preconditioning protects the brain against injury after hypothermic circulatory arrest. Circulation 123: 714, 2011.
Kuntscher MV, Juran S, Altmann J, et al: Role of nitric oxide in the mechanism of preclamping and remote ischemic preconditioning of adipocutaneous flaps in a rat model. J Reconstr Microsurg 19: 55, 2003 a.
Kuntscher MV, Kastell T, Engel H, et al: Late remote ischemic preconditioning in rat muscle and adipocutaneous flap models. Ann Plast Surg 51: 84, 2003 b.
Vasdekis SN, Athanasiadis D, Lazaris A, et al: The role of remote ischemic preconditioning in the treatment of atherosclerotic diseases. Brain Behav 3: 606, 2013.
Delagarde H, Ouadraougo N, Grall S, et al: Remote ischaemic preconditioning in intermittent claudication. Arch Cardiovasc Dis 108: 472, 2015.
Czeiger D, Dukhno O, Douvdevani A, et al: Transient extremity ischemia augments CD34+ progenitor cell availability. Stem Cell Rev 7: 639, 2011.
Shinsato T, Miyata M, Kubozono T, et al: Waon therapy mobilizes CD34 1 cells and improves peripheral arterial disease. J Cardiol 56: 361, 2010.
Wu Y, Zhao RC, Tredget EE. Concise review: bone marrow-derived stem/progenitor cells in cutaneous repair and regeneration. Stem Cell 28: 905e15, 2010.
Kraemer R, Lorenzen J, Kabbani M, et al. Acute effects of remote ischemic preconditioning on cutaneous microcirculation: a controlled prospective cohort study. BMC Surg 11: 32, 2011.
Remote ischemic conditioning involves the use of a blood pressure cuff or similar device to induce brief (3–5 min) episodes of limb ischemia. This, in turn, seems to activate a group of distress signals that has shown the potential ability to improve healing of the heart muscle and other organ systems. Until recently, this has not been tested in people with diabetic foot ulcers. The purpose of this review was to provide background on remote ischemic conditioning and recent data to potentially support its use as an adjunct to healing diabetic foot ulcers and other types of tissue loss. We believe that this inexpensive therapy has the potential to be deployed and incorporated into a variety of other therapies to prime patients for healing and to reduce morbidity in patients with this common, complex, and costly complication.