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.

Keywords: CO2 therapy; carboxy therapy; chronic wound treatment; diabetic chronic wound; diabetic foot ulcer; transcutaneous CO2 application.

FIGURE 1

Area of the wound before and after treatment in the study and control groups

FIGURE 2

Volume of the wound before and after treatment in the study and control groups

FIGURE 3

A 62‐year‐old male with diabetes and peripheral artery disease (PAD), that had persisting wounds for 8 months (A and B). Both wounds were completely in 4 weeks with transcutaneous CO₂ application (C)

FIGURE 4

A 66‐year‐old male with diabetes, PAD and Charcot arthropathy had persisting wound for 6 months (A). The wound was completely healed in 4 weeks with transcutaneous application of CO₂ (B)