Effect of Carbon Dioxide Therapy on Diabetic Foot Ulcer

Abstract

Ulceration of diabetic foot represents one of the most concerning complications associated with uncontrolled blood sugar in diabetes mellitus. The aim of this study is to evaluate the condition of twenty-two diabetic patients with different degrees of ulceration in their feet after daily secessions of carbon dioxide therapy. Blood flow to the affected foot was measured by Doppler; also the size, color, degree of ulceration and sensation of the ulcerative area were all evaluated. Results showed improvement of blood flow to the affected foot as well as improvement in the sensation and color of the ulcerative area. It was concluded that carbon dioxide therapy of diabetic foot was promising and needed thorough investigation to be brought widely into application.

The effect of transcutaneous application of gaseous CO2 on diabetic chronic wound healing—A double‐blind randomized clinical trial

“…Shalan et al performed an observational study on 22 diabetic patients with chronic wounds. 20 There was no control group. They immersed their patients' feet into CO 2− enriched water once daily for 30 minutes, for 15 days.…”

“…The importance of repetition of CO 2 therapy can be observed from comparison of Shalan's and Abdulhamzah's studies. 14,20 To the best of our knowledge, no research on humans exists investigating the effect of repetition and duration of transcutaneous CO 2 application on angiogenesis. But there are several well-designed studies on rats.…”

“…Shalan et al performed an observational study on 22 diabetic patients with chronic wounds 20 . There was no control group.…”

“…[15][16][17][18][19] To our knowledge, one randomized control trial and one observational trial have been conducted investigating the effect of CO 2 -enriched water on chronic wound treatment in humans, one observational study using transcutaneous application of CO 2 in acute and chronic wounds, and one randomized controlled study using subcutaneous CO 2 injections in chronic wound treatment. 13,14,20 All mentioned studies confirmed a positive influence on the healing of chronic wounds. In our opinion, transcutaneous application of gaseous CO 2 has some advantages compared with the other two application methods: it is not invasive like subcutaneous injections of CO 2 and it does not moisturize the wound area like CO 2 -enriched water.…”

“… 9‐18 Previous studies established a positive influence of CO 2 ‐enriched water or transcutaneous application of CO 2 for different indications, including an improvement of symptoms in Raynaud's phenomenon, intermittent claudication, stage II artheriopathy, and after surgical revascularization procedures 15‐19 . To our knowledge, one randomized control trial and one observational trial have been conducted investigating the effect of CO 2 ‐enriched water on chronic wound treatment in humans, one observational study using transcutaneous application of CO 2 in acute and chronic wounds, and one randomized controlled study using subcutaneous CO 2 injections in chronic wound treatment 13,14,20 . All mentioned studies confirmed a positive influence on the healing of chronic wounds.…”