Transcutaneous Carbon Dioxide Therapy Significantly Accelerates Diabetic Foot Ulcer Healing: A Multicentre Randomised...

Area of Science:

• Clinical Medicine
• Dermatology
• Endocrinology

Background:

• Diabetic foot ulcers (DFUs) are severe complications of diabetes mellitus (DM).
• Non-healing DFUs pose a significant clinical challenge, necessitating effective treatment strategies.
• Standard care for DFUs often requires adjunctive therapies to promote healing.

Purpose of the Study:

• To evaluate the effectiveness of transcutaneous gaseous carbon dioxide (CO2) therapy in healing non-healing DFUs.
• To compare CO2 therapy combined with standard care against standard care alone in a multicentre randomized controlled trial (RCT).
• To assess the safety and efficacy of CO2 therapy as an adjunct treatment for DFUs.

Main Methods:

• A parallel-group, open-label, superiority, multicentre RCT involving 115 patients with non-healing DFUs.
• Participants were randomized to receive standard care plus CO2 therapy (intervention group, n=76) or standard care alone (control group, n=39).
• CO2 therapy was administered weekdays for four weeks; outcomes were assessed after this period.

Main Results:

• A significantly higher proportion of ulcers healed in the CO2 therapy group (64.5%) compared to the control group (7.7%) after 4 weeks (p < 0.001).
• The intervention group showed a significantly greater percentage reduction in ulcer area from baseline (median 100%) versus the control group (median 40%).
• CO2 therapy was associated with 35.4-fold higher odds of ulcer healing, and no adverse effects were reported.

Conclusions:

• Transcutaneous gaseous carbon dioxide therapy is a safe and effective complementary treatment for non-healing diabetic foot ulcers.
• CO2 therapy significantly enhances ulcer healing rates and area reduction when used alongside standard care.
• This therapy demonstrates substantial potential for improving outcomes in patients suffering from diabetic foot complications.