Continuous diffusion of oxygen improves diabetic foot ulcer healing when compared with a placebo control: A randomised, double-blind, multicentre study

Mark Q. Niederauer, Joel E Michalek, Qianqian Liu, Klearchos K. Papas, Lawrence A. Lavery, David G. Armstrong

Research output: Contribution to journalArticle

7 Scopus citations


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 56.312.4 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). Declaration of interest: MQN is a full-time employee of EO2 Concepts. DGA and LAL are a member of the scientific advisory board of EO2 concepts. The other authors have no conflict of interest to declare.

Original languageEnglish (US)
Pages (from-to)S30-S45
JournalJournal of wound care
StatePublished - Sep 1 2018
Externally publishedYes



  • closure rate
  • continuous diffusion of oxygen
  • diabetic foot ulcer
  • moist wound therapy
  • tissue oxygenation
  • wound healing

ASJC Scopus subject areas

  • Fundamentals and skills
  • Nursing (miscellaneous)

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