title: The role of carbon dioxide therapy in the treatment of chronic wounds.
abstract: A wound is defined as chronic when it does not heal according to the normal repair times and mechanisms. This particular condition may be principally due to local hypoxia. Carbon dioxide (CO(2)) therapy refers to the transcutaneous or subcutaneous administration of CO(2) for therapeutical effects on both microcirculation and tissue oxygenation. In this study, we report the clinical and instrumental results of the application of CO(2) in the therapy of chronic wounds. The study included 70 patients affected by chronic ulcers. The patients were selected by aetiology and wound extension and equally divided into two homogeneous groups. In group A, CO(2) therapy was used in addition to the routine methods of treatment for such lesions (surgical and/or chemical debridement, advanced dressings according to the features of each lesion). In group B, patients were treated using routine methods alone. Both groups underwent to instrumental (laser doppler flow, measurement of TcPO(2)), clinical and photographic evaluation. In the group that underwent subcutaneous treatment with CO(2) therapy, the results highlighted a significant increase in tissue oxygenation values, which was confirmed by greater progress of the lesions in terms of both healing and reduction of the injured area. Considering the safety, efficacy and reliability of this method, even if further studies are necessary, we believe that it is useful to include subcutaneous carbon dioxide therapy in the treatment of wounds involving hypoxia-related damage.
authors.affiliation: Plastic Surgery Unit, Department of General and Specialist Surgery, University of Siena, Polyclinic S. Maria alle Scotte, Viale Bracci, 53100 Siena, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Brandi
authors.forename: Luca
authors.initials: L
authors.lastname: Grimaldi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nisi
authors.forename: Anna
authors.initials: A
authors.lastname: Brafa
authors.forename: Alessandra
authors.initials: A
authors.lastname: Campa
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Calabrò
authors.forename: Matteo
authors.initials: M
authors.lastname: Campana
authors.forename: Carlo
authors.initials: C
authors.lastname: D'Aniello
mesh_terms: D000368:Aged; D001458:Bandages; D002245:Carbon Dioxide / Q000627:therapeutic use*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000098:blood supply*; D014456:Ulcer / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology; D014947:Wounds and Injuries / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*
chemical_list: D002245:Carbon Dioxide