{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:58:45Z","timestamp":1777712325265,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T00:00:00Z","timestamp":1606089600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      Infection, which is one of the possible complications of diabetic foot ulcers (DFUs), makes the treatment of ulcers challenging because of its negative impact on healing processes and the high prevalence of multiresistant germs. This study is aimed at verifying the effect of a surgical CO\n                      <jats:sub>2<\/jats:sub>\n                      laser (which reduces the bacterial load and allows a more accurate debridement), as compared with the traditional lancets, on the healing rate of DFU.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The present case-control retrospective analysis was performed on patients with chronic (&gt;6 months) DFU with Texas grade &gt;1, treated with 80 W surgical CO\n                      <jats:sub>2<\/jats:sub>\n                      laser (DEKA SmartXide2 C80, El.En. Group) and compared with a matched sample of patients with similar characteristics, who were treated with a traditional surgical approach. The debridement was performed trying to achieve the complete removal of nonviable tissues. The principal endpoint was the proportion of patients healed at 6 months. All analyses were carried out with SPSS 25.0. The study protocol was approved by the local ethical committee.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study included 118 patients (59 cases and 59 controls). At 6 months, the proportion of healing patients was 35% and 18% in cases and controls, respectively ( P = .034). The corresponding figure at 1 year was 62% and 38% ( P = .009), whereas no difference was observed at 1, 2, and 3 months. No serious adverse event was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this article, we show for the first time that CO\n                      <jats:sub>2<\/jats:sub>\n                      laser treatment, in comparison with traditional surgical approaches, can be associated with an increased healing rate in patients with DFU.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1534734620960298","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T06:42:30Z","timestamp":1606113750000},"page":"471-476","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Retrospective Matched Case-Control Study on the Use of CO\n                    <sub>2<\/sub>\n                    Laser for the Treatment of Nonhealing Diabetic Foot Ulcers: The DULCIS-2 (Diabetic ULcer, CO\n                    <sub>2<\/sub>\n                    Laser, and Infections) Study"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9349-828X","authenticated-orcid":false,"given":"Matteo","family":"Monami","sequence":"first","affiliation":[{"name":"Careggi Hospital and University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"Ragghianti","sequence":"additional","affiliation":[{"name":"Careggi Hospital and University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Silverii","sequence":"additional","affiliation":[{"name":"Careggi Hospital and University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Scatena","sequence":"additional","affiliation":[{"name":"San Donato Hospital, Arezzo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Letizia","family":"Landi","sequence":"additional","affiliation":[{"name":"Careggi Hospital and University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Cosentino","sequence":"additional","affiliation":[{"name":"Careggi Hospital and University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Vitale","sequence":"additional","affiliation":[{"name":"Careggi Hospital and University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Mannucci","sequence":"additional","affiliation":[{"name":"Careggi Hospital and University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,11,23]]},"reference":[{"key":"bibr1-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"bibr2-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13054"},{"key":"bibr3-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2007.00283.x"},{"key":"bibr4-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.06.006"},{"key":"bibr5-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1186\/s12929-016-0250-7"},{"key":"bibr6-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.10.003"},{"key":"bibr7-1534734620960298","unstructured":"Moffatt CJ. Position document: wound bed preparation in practice. Published 2004. Accessed October 21, 2020. https:\/\/ewma.org\/fileadmin\/user_upload\/EWMA.org\/Position_documents_2002-2008\/pos_doc_English_final_04.pdf"},{"key":"bibr8-1534734620960298","volume":"22","author":"Strohal R","year":"2014","journal-title":"J Wound Care"},{"key":"bibr9-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2013.09.013"},{"key":"bibr10-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(97)70277-8"},{"key":"bibr11-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.1900110514"},{"key":"bibr12-1534734620960298","first-page":"359","volume":"32","author":"Manolis EN","year":"2006","journal-title":"Dermatol Surg"},{"key":"bibr13-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2009.01.004"},{"key":"bibr14-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9101(2000)26:1<22::AID-LSM5>3.0.CO;2-R"},{"key":"bibr15-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-017-0666-2"},{"key":"bibr16-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12399"},{"key":"bibr17-1534734620960298","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-865020150120000010"},{"key":"bibr18-1534734620960298","unstructured":"Lipsky BA, Aargon-Sanchez J, Diggle M, et al; International Working Group on the Diabetic Foot. 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