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Effect of Cryotherapy Devices in the Postoperative Setting

Naohiro Shibuya, DPM ^*, Theresa L. Schinke, DPM , Michael B. Canales, DPM  and Gerard V. Yu, DPM 

^* Orthopaedics/Podiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Private practice, Northeast Wisconsin Foot & Ankle, Appleton, WI.
Podiatric Surgery, St Vincent Charity Hospital, Cleveland, OH.
Private practice, Podiatric Surgery, North Olmstead, OH; now deceased.

Corresponding author: Naohiro Shibuya, DPM, Orthopaedics/Podiatry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, Mail Code #7776, San Antonio, TX 78229.

Abstract

Background: Sophisticated methods of cryotherapy, such as application of a water-circulating device, have recently been popularized to provide a constant or intermittent therapeutic source in the foot and ankle postoperative setting. In this study, the efficacy and safety of three selected cryotherapy devices (Iceman, EBIce, and Ankle Cryo/Cuff) were investigated.

Methods: Each cryotherapy unit, in the coldest setting, was applied over standard surgical dressings in group I, over one layer of Jones compression bandage in group II, and over two layers of Jones compression bandage in group III on four individuals in excellent overall health. The skin temperature was then recorded every 15 min for 180 min in each trial.

Results: In group I, the Iceman was the only device that required discontinuation in one subject, and the EBIce and Cryo/Cuff were tolerated in all of the subjects. However, the temperatures in all of the devices continued to decrease at the end of the trials. In group II, all of the cryotherapy devices controlled temperatures between 20°C (68°F) and 30°C (86°F). In group III, no device significantly lowered the initial surface skin temperature.

Conclusions: We achieved the safe and effective temperature range when the cryotherapy devices were applied over one layer of Jones compression dressing. The cryotherapy devices resulted in less predicable temperature declination when applied over the thinner surgical dressing. When the devices were applied over two layers of Jones compression dressing, surface skin temperature declination was minimal. (J Am Podiatr Med Assoc 97(6): 439–446, 2007)