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

Abstract

Chronic wounds in diabetics are difficult to treat, therefore, adjuvant therapies have been investigated. Bathing in CO2‐rich water (spa therapy) has been known in Europe for decades for its positive effect on peripheral vascular disorders. Recently, much effort has been invested in developing optimal application methods of CO2. Uses include subcutaneous injections of CO2, bathing in CO2‐enriched water, and transcutaneous application of CO2. To verify the effect of transcutaneous application of gaseous CO2 on the healing of chronic diabetic wounds, a randomized double‐blind clinical research was designed. The research included 30 and 27 wounds in the study and control groups, respectively. In addition to standard treatment, patients in the study group received 20 therapies with medical‐grade CO2 gas and the control group received the same treatment with air. Results showed significantly faster healing in the study group: 20 of the 30 wounds in the study group were healed compared with none in the control group. Mean wound surface and volume in the study group was reduced significantly (surface: 96%, P = .001, volume: 99%, P = .003) compared with a small reduction in the control group (surface: 25%, P = .383, volume: 27%, P = .178). Considering our results, transcutaneous application of gaseous CO2 is an effective adjuvant therapy in diabetic chronic wound treatment.

Carboxytherapy in dermatology: A systematic review

“…Macura et al 33 measured the area and volume of the wound (induced by either ischemia or neuropathy or a combination) before and after therapy while also assessing the wound bed. They found that 20 (approximately 67%) wounds receiving carboxytherapy healed utterly, while all three mentioned parameters improved significantly in the remaining ones ( p ‐value = 0.001).…”

Analgesic Effect of Carboxytherapy for Postoperative Neuropathic Facial Pain: A Case Report

“…Carboxytherapy is a well-known technique in dermatology, and it has been used for several years for both aesthetic and pathological conditions [3][4][5][6]. It is considered a simple and safe procedure, with mostly mild and temporary adverse events such as pain and bruising [5].…”

Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update)

“…[100][101][102][103][104][105][106][107][108][109] In addition, we found one study on nitric oxide, 110 three on ozone therapy, [111][112][113] two on cold atmospheric plasma 114,115 , and one on carbon dioxide. 116 With all of these studies being either at high risk of bias and/or with lack of demonstrable effect, these were grouped together as 'other gases'. Rationale: Of the 18 studies on the evaluation of the use of hyperbaric oxygen as an adjunct therapy to improve diabetes-related foot ulcer healing, only three were double-blinded RCTs.…”