Background: Diabetic wounds and ulcers are serious complications in diabetic patients that need a long time and high-cost treatment. There are different physical therapy modalities used in wound care; as Laser therapy, magnetic therapy, negative pressure wound therapy and cryo-air therapy.
Objectives: this study was conducted to investigate the effect of combining therapy between negative pressure wound therapy (NPWT) and cryo-air therapy on diabetic wound healing. Patients and Methods: Sixty  diabetic patients with large infected diabetic wounds with age between 40-60 years, positive wound culture after surgical debridement selected and randomly divided into three equal groups, group A received routine medical wound care plus NPWT 3 times/ week for 8 weeks, group B received routine medical wound care plus cryotherapy air 3 times/ week for 8 weeks, group C received routine medical wound care plus NPWT followed by cryotherapy air application 3 times/ week for 8 weeks. The patients were assessed by wound surface area and wound culture before treatment, after 4 weeks of treatment, and at the end of treatment (after 8 weeks).
Results: there was a significant decrease in wound volume at the post I and post II compared with that at pretreatment in the three groups.  Also, there was a significant decrease in wound volume at post-II compared with that at the post I in the three groups. Also, there was a significant decrease in the positive culture at the post I compared with that pretreatment in group B and C and a significant decrease in the positive culture at the post II compared with pretreatment in group A, B and C. There was a significant decrease in positive wound culture of the group C at post I and post II compared with that of the group A and group B. There was a significant decrease in positive wound culture of the group B compared with that of the group A in the post I and at post II.
Conclusion:  cryo-air therapy and negative pressure wound therapy have a positive effect on wound healing but its combination is more effective.