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A Simplified Technique for Producing an Ischemic Wound Model
Published on: May 2, 2012
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Gas Therapies for Chronic Wounds: Comparative Effectiveness, Safety, and Evidence Certainty-A Systematic Review and
Xinghui Zheng1, Tianbo Li1, Jiangning Wang1
1Orthopedic Department, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, China.
Journal of Clinical Medicine
|April 14, 2026
Summary
Gas therapies improve chronic wound healing compared to standard care, but effectiveness varies by type and wound etiology. Hyperbaric oxygen therapy (HBOT) has the most evidence, but more research is needed for definitive rankings.
Area of Science:
- Wound healing research
- Medical therapies
- Evidence-based medicine
Background:
- Chronic wounds pose a significant clinical challenge.
- Gas-based therapies offer potential treatment modalities.
- Comparative efficacy of different gas therapies is not well-established.
Purpose of the Study:
- To systematically review and network meta-analyze the efficacy and safety of gas-based therapies for chronic wounds.
- To compare various gas modalities against standard care and each other.
- To rank gas therapies based on evidence of complete wound healing.
Main Methods:
- Systematic search of multiple databases (PubMed, Embase, Web of Science, Cochrane CENTRAL, CBM) up to October 2025.
- Inclusion of randomized controlled trials (RCTs) in adults with chronic wounds.
- Pairwise meta-analysis and frequentist network meta-analysis (NMA) using risk ratios (RRs), heterogeneity assessment (I²), and treatment ranking (SUCRA).
Main Results:
- Twenty-seven RCTs with 1673 participants were analyzed.
- Gas therapies collectively increased complete healing versus standard care (RR = 2.17), with significant heterogeneity (I² = 75.7%).
- Network meta-analysis showed varied effectiveness; standard care ranked highest (SUCRA 93.9%), followed by ozone therapy and topical oxygen. Hyperbaric oxygen therapy (HBOT) and cold atmospheric plasma were mid-range; CO₂ therapy ranked lowest. Evidence certainty was moderate, limited by heterogeneity, imprecision, and potential publication bias.
Conclusions:
- Gas therapies, as a class, enhance chronic wound healing probability compared to standard care, but efficacy differs by modality and wound type.
- Findings should be interpreted cautiously due to heterogeneity, potential publication bias, and network inconsistencies.
- HBOT has the most robust evidence base; high-quality RCTs are needed to clarify comparative effectiveness and safety rankings of gas therapies.
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