A systematic review of ozone therapy for treating chronically refractory wounds and ulcers

Abstract

This study aims at evaluating the efficacy and safety of ozone therapy for chronic wounds. The Cochrane Library, PubMed, Ovid Embase, Web of Science, and Chinese Biomedical Literature Database were searched. Randomised controlled trials (RCTs) about participants with chronic wounds were included. Risk of bias assessment was performed by the Cochrane risk-of-bias tool. A randomised-effects model was applied to pool results according to the types of wounds or ulcers. Among 12 included studies, ozone was implemented by topical application (ozone gas bath, ozonated oil, ozone water flushing) and systematic applications including autologous blood immunomodulation and rectal insufflation. The results indicated compared with standard control therapy for diabetic foot ulcers, ozone therapy regardless of monotherapy or combined control treatment markedly accelerated the improvement of the wound area(standardised mean difference(SMD) = 66.54%, 95% confidence interval (CI) = [46.18,86.90], P < .00001) and reduced the amputation rate (risk ration (RR) = 0.36, 95% CI = [0.24,0.54], P < .00001). But there is no improvement in the proportion of participants with completely healed wounds and length of hospital stay. No adverse events associated with ozone treatment have been reported. And the efficacy of ozone therapy for other wound types is still uncertain because of no sufficient studies. More high-quality randomised controlled trials are needed to confirm the efficacy and safety of ozone therapy for chronic wounds or ulcers.

Risks of ozonated oil and ozonated water on human skin: A systematic review

“…In the international literature, there are many such references to the utilisation of ozonated liquids in clinical practice, 5 implying that these agents are widely used and accepted treatment modalities. A recent systematic review by Wen and colleagues 6 demonstrated that ozone therapy markedly accelerated the improvement of chronic wounds and reduced the amputation rate. Other studies that include liquid forms of O 3 are often of small sample size and lack validation with large randomised controlled trials (RCTs); however, they have shown promising results in the management of venous stasis ulcers, 7 burns, 8 atopic dermatitis, 9 , 10 tinea pedis, 11 , 12 , 13 hand sanitation, 14 diabetic foot ulcers, 15 and other dermatologic conditions.…”

Ozone Therapy in the Comprehensive Treatment of Leg Ulcers: Case Report

“…Because of these properties, ozone can successfully be used in the treatment of difficult chronic wounds, including infected wounds. [9][10][11]…”

“…The oxidation of these compounds leads to changes in the permeability of cell membranes and to the secondary oxidation of proteins that are part of the enzymatic system in the cytoplasm, resulting in bactericidal properties. Because of these properties, ozone can successfully be used in the treatment of difficult chronic wounds, including infected wounds 9–11 …”

Studio di valutazione del presidio Rigenoma con ozoile nel trattamento di lesioni cutanee croniche

“…Questa tipologia di prodotto presenta ormai una importante letteratura a sostegno. Wen et al, in una recente review della letteratura, 10 riportano l'utilizzo di ozonidi topici nel trattamento di ulcere post attiniche, venose, ulcere digitali in sclerodermia, ulcere arteriose e piede diabetico; a fronte dell'assenza di evidenza nelle lesioni attiniche, in tutte le altre tipologie viene riportata una accelerazione della riparazione ma, i dati, non sarebbero significativi; l'autore sottolinea però un basso livello degli studi. Lim et al, in un'altra review, 11 segnalano un effetto positivo sul wound healing legato all'attività battericida, antifungina ed antivirale degli oli ozonizzati.…”