Effect of Transcutaneous Application of Carbon Dioxide on Wound Healing, Wound Recurrence Rate and Diabetic Polyneuropathy in Patients with Neuropathic, Ischemic and Neuroischemic Diabetes-Related Foot Ulcers

(1) Background: Diabetes-related foot ulcers (DFUs) are a severe complication of diabetes mellitus (DM), with a five-year mortality rate of around 40%. Our study aimed to explore the effects of transcutaneous application of carbon dioxide (CO<sub>2</sub> therapy) on DFU healing and recur...

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Main Authors: Tomislav Bulum, Tamara Poljičanin, Anica Badanjak, Jelena Držič, Željko Metelko
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/4/618
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author Tomislav Bulum
Tamara Poljičanin
Anica Badanjak
Jelena Držič
Željko Metelko
author_facet Tomislav Bulum
Tamara Poljičanin
Anica Badanjak
Jelena Držič
Željko Metelko
author_sort Tomislav Bulum
collection DOAJ
description (1) Background: Diabetes-related foot ulcers (DFUs) are a severe complication of diabetes mellitus (DM), with a five-year mortality rate of around 40%. Our study aimed to explore the effects of transcutaneous application of carbon dioxide (CO<sub>2</sub> therapy) on DFU healing and recurrence rate, as well as diabetic polyneuropathy. (2) Methods: Adults with at least one chronic DFU were invited to undergo 20 50-min-long CO<sub>2</sub> therapies within 4 weeks. After the completion of the last CO<sub>2</sub> therapy, the effect of the therapies on wound healing and diabetic polyneuropathy was assessed, and 1 year later, we evaluated the incidence rate of DFU recurrence. (3) Results: Thirty-five subjects with DM and forty DFUs (ischemic: 15, neuropathic: 8, neuroischemic: 17) participated in our trial. After 4 weeks, 67.5% of all DFUs healed, whereas the reduction of the surface area of the unhealed wounds (74.0% ± 22.3%) was statistically significant. The restoration of protective sensations was also statistically significant. All unhealed wounds received standard care and healed within 2 additional weeks. The recurrence rate after 1 year was 17.5%. None of the patients required antibiotic treatment, hospitalization, or amputation. (4) Conclusion: CO<sub>2</sub> therapy is a promising therapeutic intervention for treating DFUs and improving diabetic polyneuropathy.
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spelling doaj-art-13fccf59944844688dc72af01bba24462025-08-20T02:28:15ZengMDPI AGLife2075-17292025-04-0115461810.3390/life15040618Effect of Transcutaneous Application of Carbon Dioxide on Wound Healing, Wound Recurrence Rate and Diabetic Polyneuropathy in Patients with Neuropathic, Ischemic and Neuroischemic Diabetes-Related Foot UlcersTomislav Bulum0Tamara Poljičanin1Anica Badanjak2Jelena Držič3Željko Metelko4Clinical Hospital Merkur, University Clinic for Diabetes, Endocrinology, and Metabolic Diseases Vuk Vrhovac, Dugi dol 4a, 10000 Zagreb, CroatiaZagreb County Health Center, Ljudevita Gaja 37, 10430 Samobor, CroatiaPolyclinic for Physical Medicine and Rehabilitation with Physical Therapy, Vascular Surgery, Neurology, Endocrinology, and Diabetology, Kalinovica 3, 10000 Zagreb, CroatiaPolyclinic for Physical Medicine and Rehabilitation with Physical Therapy, Vascular Surgery, Neurology, Endocrinology, and Diabetology, Kalinovica 3, 10000 Zagreb, CroatiaPolyclinic for Physical Medicine and Rehabilitation with Physical Therapy, Vascular Surgery, Neurology, Endocrinology, and Diabetology, Kalinovica 3, 10000 Zagreb, Croatia(1) Background: Diabetes-related foot ulcers (DFUs) are a severe complication of diabetes mellitus (DM), with a five-year mortality rate of around 40%. Our study aimed to explore the effects of transcutaneous application of carbon dioxide (CO<sub>2</sub> therapy) on DFU healing and recurrence rate, as well as diabetic polyneuropathy. (2) Methods: Adults with at least one chronic DFU were invited to undergo 20 50-min-long CO<sub>2</sub> therapies within 4 weeks. After the completion of the last CO<sub>2</sub> therapy, the effect of the therapies on wound healing and diabetic polyneuropathy was assessed, and 1 year later, we evaluated the incidence rate of DFU recurrence. (3) Results: Thirty-five subjects with DM and forty DFUs (ischemic: 15, neuropathic: 8, neuroischemic: 17) participated in our trial. After 4 weeks, 67.5% of all DFUs healed, whereas the reduction of the surface area of the unhealed wounds (74.0% ± 22.3%) was statistically significant. The restoration of protective sensations was also statistically significant. All unhealed wounds received standard care and healed within 2 additional weeks. The recurrence rate after 1 year was 17.5%. None of the patients required antibiotic treatment, hospitalization, or amputation. (4) Conclusion: CO<sub>2</sub> therapy is a promising therapeutic intervention for treating DFUs and improving diabetic polyneuropathy.https://www.mdpi.com/2075-1729/15/4/618diabetic footdiabetes-related foot ulcerCO<sub>2</sub> therapytranscutaneous CO<sub>2</sub> applicationwound healingdistal symmetrical polyneuropathy
spellingShingle Tomislav Bulum
Tamara Poljičanin
Anica Badanjak
Jelena Držič
Željko Metelko
Effect of Transcutaneous Application of Carbon Dioxide on Wound Healing, Wound Recurrence Rate and Diabetic Polyneuropathy in Patients with Neuropathic, Ischemic and Neuroischemic Diabetes-Related Foot Ulcers
Life
diabetic foot
diabetes-related foot ulcer
CO<sub>2</sub> therapy
transcutaneous CO<sub>2</sub> application
wound healing
distal symmetrical polyneuropathy
title Effect of Transcutaneous Application of Carbon Dioxide on Wound Healing, Wound Recurrence Rate and Diabetic Polyneuropathy in Patients with Neuropathic, Ischemic and Neuroischemic Diabetes-Related Foot Ulcers
title_full Effect of Transcutaneous Application of Carbon Dioxide on Wound Healing, Wound Recurrence Rate and Diabetic Polyneuropathy in Patients with Neuropathic, Ischemic and Neuroischemic Diabetes-Related Foot Ulcers
title_fullStr Effect of Transcutaneous Application of Carbon Dioxide on Wound Healing, Wound Recurrence Rate and Diabetic Polyneuropathy in Patients with Neuropathic, Ischemic and Neuroischemic Diabetes-Related Foot Ulcers
title_full_unstemmed Effect of Transcutaneous Application of Carbon Dioxide on Wound Healing, Wound Recurrence Rate and Diabetic Polyneuropathy in Patients with Neuropathic, Ischemic and Neuroischemic Diabetes-Related Foot Ulcers
title_short Effect of Transcutaneous Application of Carbon Dioxide on Wound Healing, Wound Recurrence Rate and Diabetic Polyneuropathy in Patients with Neuropathic, Ischemic and Neuroischemic Diabetes-Related Foot Ulcers
title_sort effect of transcutaneous application of carbon dioxide on wound healing wound recurrence rate and diabetic polyneuropathy in patients with neuropathic ischemic and neuroischemic diabetes related foot ulcers
topic diabetic foot
diabetes-related foot ulcer
CO<sub>2</sub> therapy
transcutaneous CO<sub>2</sub> application
wound healing
distal symmetrical polyneuropathy
url https://www.mdpi.com/2075-1729/15/4/618
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