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Continuous Diffusion of Oxygen Therapy Cost-Effective for Advanced Diabetic Foot Ulcers

November 19, 2020

Treating patients with advanced diabetic foot ulcers using continuous delivery of oxygen (CDO) therapy cost less and offered better outcomes compared with negative pressure wound therapy, according to a study published online in the International Wound Journal. 

“The results of this economic evaluation suggest that CDO therapy may reduce health care economic burden with a modest increase in quality of life outcomes,” researchers wrote. “Health care decision‐makers should consider the inclusion of CDO for the treatment of diabetic foot ulcers.” 

Noting that the intervention appears to improve healing but requires the purchase of an oxygen delivery device as well as moist dressings, researchers investigated whether CDO therapy was cost-effective. To do so, they used data from published studies and reports to create a microsimulation model that compared CDO therapy with negative pressure wound therapy. The cost-effective analysis took the perspective of the public health care payer in Ontario, Canada.

In a simulated cohort of 10,000 patients, the model estimated 32% would have wound closure after CDO therapy compared with 27% after negative pressure wound therapy, according to the study. The average 5-year cost per patient receiving CDO in the base case was an estimated $78,500 compared with $83,300 for negative pressure wound therapy, resulting in a savings of $4800 with CDO. 

The study also found average 5-year quality-adjusted life-years per patient increased 3.650 with CDO and 3.625 with negative pressure wound therapy, leading to a 0.025 quality-adjusted life-year gain with CDO therapy. 

Most scenario analyses in the study found lower costs and better outcomes with CDO, researchers reported. 

“Individuals with hard to heal diabetic foot ulcers face an increased risk for secondary complications, amputation, and death associated with the unhealed wound. Treatment for this population includes interventions that are costly, time‐consuming, inconvenient, and/or unavailable,” they wrote. “CDO provides a potential treatment option that may be less costly than other treatment options using a device that is portable and allows for individuals to conduct dressing changes on their own.” 

Jolynn Tumolo 


Chan BC, Campbell KE. An economic evaluation examining the cost-effectiveness of continuous diffusion of oxygen therapy for individuals with diabetic foot ulcers [published online ahead of print, 2020 Jul 27]. Int Wound J. 2020;10.1111/iwj.13468. doi:10.1111/iwj.13468

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