Mark Q Niederauer1, Joel E Michalek2, Qianqian Liu3, Klearchos K Papas4, Lawrence A Lavery5, David G Armstrong6. 1. EO2 Concepts, San Antonio, TX, US. 2. Professor and Vice-Chair of Department of Epidemiology and Biostatistics, UT Health, San Antonio, TX, US. 3. Biostatistician-Associate in Department of Epidemiology and Biostatistics, UT Health, San Antonio, TX, US. 4. Scientific Director of Institute for Cellular Transplantation, University of Arizona, Tucson, AZ, US. 5. Professor of Plastic Surgery, Orthopaedic Surgery and Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, US. 6. Professor of Clinical Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, US.
Abstract
OBJECTIVE: The aim of this study was to assess whether continuous diffusion of oxygen improves healing in people receiving treatment for diabetic foot ulcers (DFU). METHOD: A double-blind, placebo control randomised study to receive either active continuous diffusion of oxygen (CDO) therapy using an active CDO device, or a fully operational placebo device without delivering oxygen. Patients were followed until closure or 12 weeks. Patients, caretakers, treating physicians and independent evaluators were blinded to the study arm. All patients received identical offloading, debridement, dressings and follow-up. RESULTS: We enrolled 146 people with DFUs (77% male, aged 56.3±12.4 years). A significantly higher proportion (195%) of DFUs healed in the CDO arm compared with placebo (32.4% versus 16.7%, p=0.033). The time to 50% DFU closure was significantly shorter in patients that received CDO therapy (mean 18.4 versus 28.9 days, p=0.001). There were no differences in overall adverse events (p=0.66) or ulcer-related adverse events (p=0.30) in the active and placebo treatment groups. The relative performance of active CDO over placebo became greater when used in larger wounds (273%), in more chronic wounds (334%) and in weight bearing wounds (465%). CONCLUSION: The results of this study demonstrate that CDO leads to higher proportion of healed DFUs (p=0.033) and a faster time to closure compared with placebo in people with DFUs (p=0.015). Relative performance did not vary significantly with wound size (p=0.80), but revealed better relative performance in more chronic wounds (p=0.008) and in weight-bearing wounds (p=0.003).
RCT Entities:
OBJECTIVE: The aim of this study was to assess whether continuous diffusion of oxygen improves healing in people receiving treatment for diabetic foot ulcers (DFU). METHOD: A double-blind, placebo control randomised study to receive either active continuous diffusion of oxygen (CDO) therapy using an active CDO device, or a fully operational placebo device without delivering oxygen. Patients were followed until closure or 12 weeks. Patients, caretakers, treating physicians and independent evaluators were blinded to the study arm. All patients received identical offloading, debridement, dressings and follow-up. RESULTS: We enrolled 146 people with DFUs (77% male, aged 56.3±12.4 years). A significantly higher proportion (195%) of DFUs healed in the CDO arm compared with placebo (32.4% versus 16.7%, p=0.033). The time to 50% DFU closure was significantly shorter in patients that received CDO therapy (mean 18.4 versus 28.9 days, p=0.001). There were no differences in overall adverse events (p=0.66) or ulcer-related adverse events (p=0.30) in the active and placebo treatment groups. The relative performance of active CDO over placebo became greater when used in larger wounds (273%), in more chronic wounds (334%) and in weight bearing wounds (465%). CONCLUSION: The results of this study demonstrate that CDO leads to higher proportion of healed DFUs (p=0.033) and a faster time to closure compared with placebo in people with DFUs (p=0.015). Relative performance did not vary significantly with wound size (p=0.80), but revealed better relative performance in more chronic wounds (p=0.008) and in weight-bearing wounds (p=0.003).
Authors: Pamela Chen; Keryln Carville; Terry Swanson; Peter A Lazzarini; James Charles; Jane Cheney; Jenny Prentice Journal: J Foot Ankle Res Date: 2022-05-25 Impact factor: 3.050
Authors: Jessica Izhakoff Yellin; Julia A Gaebler; Frank F Zhou; Timothy Niecko; Olivia Novins; Amelia Ockert; Darcy Krzynowek; Matthew G Garoufalis; Aliza M Lee; Robert G Frykberg Journal: Adv Wound Care (New Rochelle) Date: 2021-12-06 Impact factor: 4.947