Carbon dioxide infusion: clinical and histological appraisal in chronic wounds

The application of medical carbon dioxide gas through the skin is a non surgical procedure applied via percutaneous, transdermal and subcutaneous. Increase in the concentration of carbon dioxide decreases pH activating local nitric oxide that stimulates collateral vessels formation, vascular endothelial growth factor and basic fibroblast growth factor. The volume of carbon dioxide injected was 1.5mlCO2/kg per puncture per session by wound with a pressure flow of 80mlCO2/min. Carbon dioxide was applied on wounds of Group I with a 30G 1/2 needle attached to a digital, programmable, gas heated carbon dioxide device, Carbtek Advanced by ESTEK Tecnologia em Produtos - DAF Produtos Hospitalares Ltda EPP. Punctures were done 2.5cm distant from each other along the border of the wound with the needle pointed toward the granulation tissue. Carbon dioxide infusions were performed at intervals of 4 days, each one constituting an individual time of observation or session. The wounds on both lower limbs were caused by venous insufficiency, ranging from 10 to 14 months, mean of 11.7 months for Group I and 11.3 months for Group II. Carbon dioxide infusions were performed at intervals of 4 days, each one constituting an individual time of observation or session. It was repeated until a brilliant red color with small bleeding during the dressing exchange might be found on the granulation tissue.