1. Carboxy Therapy

2. CARBOXITHERAPY What is it?
It is a non surgical method which consists of injecting CO2 at subcutaneous level through a very fine needle (3mm) by using an equipment especially designed for regulating the gas exit with a low pressure.

3. Characteristics of CO2 Non scent, colorless, soluble in water
Final product of the organic metabolism
High disolution ( 20 times more than O2 in the microcirculation)
Modest transformation in HCO3

4. Origen of Carboxitherapy
1930 : France . Gas de Royat. Arteriopaties
1930 : Argentine Medical Association
1953: Publication of 20 experienced years with subcutaneous injections

5. Action mecanisms. Active Vaso-dilatation
Increment of oxidatve phenomena
Arteriolization of blood (Bohr effect)
Increasing of cellular oxygenation
Lipolitic effect
Sympatic-litic effect

6. Toxicity Absence of toxicity with high dose
Absence of increment in the systemic TA
No variations in the systemic partial pressure of O2 and CO2

7. Medical directions Angiology: Arteriopaties, microangiopaties
Reumatology: Arthritis
Urology: Erectil disfunction by angiopaties
Dermatology: Psoriasis, ulcers related to microangiopaties.

8. Therapeutic directions
Vascular and artery pathologies
Acute arthritis
Sports Medicine
Healing defects

9. Aesthetic indications
Cellulitis
Located adiposity
Pre liposculpture
Pos lipoescuplture

10. Contraindications IAM, unstable anginas ICC HTA Acute tromboflebitis
Located Infections
Epilepsy
Pregnancy
Renal and respiratory insufficiencies

26. Treatment sessions
Between 15 and 20 sessions of approximately 10 minutes each, are suggested according to the different cases. The intensity per week is 2 or 3.

27. Treatment protocol
The suggested dose of CO2 per member should oscillate between 100 and 200 cc.
Divide the treated zone into 4 or 6 quadrants in eah member. It is suggested not to inject more than 30 o 50 cc per zone.
It is convenient to jab in several directions.
Injections should be complemented with manual massages to spread the gas, control the efisema and dicrease the annoyance on the patient

28. Clinic cases
Patient with multiple symmetrical lipomatosis; pre-surgery situation (frontal)
Patient with multiple symmetrical lipomatosis; pre-surgery situation (lateral)

29. Clinic cases
. Patient with multiple symmetrical lipomatosis; pos-surgery situation (frontal)
Patent with multiple symmetrical lipomatosis; pos surgery situation (lateral)

30. Microphotograph
Figure1. Microphotograph of the abdominal subcutaneous weave on the patient with multiple symmetrical lipomatosis : biopsy before the treatment with CO2
Figure 2. Microphotography of the abdominal subcutaneous weave on the patient with multiple symmetrical lipomatosis : biopsy after the treatment with CO2. The areas of lisis adipocitaries are evident, with conservation of the anatomic integrity of the vascular system.

31. Bibliography
Hartmann B.R., Bassenge E., Pittler M.: «Effect of carbon dioxide enriched water on the cutaneous mícrocirculation and oxygen tension in the skin of the foot». Angiology, 48, 957, 1997.
Klopstock T., Naumann M., Seibel P., et al.: «Mitocondrial DNA mutations in multiple Symmetric lipomatosis». Mol. Cell. Biochem., 17, 271, 1997.
Savin E., Bailliart O., Bonnin P., et al.: «Vasomotor effects of transcutaneous CO2 in stage. Il peripheral occlusive arterial disease». Angiology, 46, 785, 1995.
Smith P.D., Stadelmann W.K., Wassemann R.J., et al.: «Benign symmetric lipomatosis (Madelung's disease)». Ann. Plast. Surg., 41, 671, 1998.
Stavropoulos P.G., Wouboulis C.C., Trautmann C., et al.: «Symmetric lipomatoses in female patients». Dermatology, 194, 26, 1997.

32. THANKS FOR YOUR ATENTION