Keywords
Ozone Therapy
Review
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Abstract
Objective: To analyze the available clinical evidence on the application of ozone therapy as a treatment for refractory ulcers. Methods: This is an integrative review, conducted in the SciELO, PubMed, Scopus, and Web of Science databases, using the following descriptors: "Chronic Wounds", "Wound Healing", "Skin Ulcer", "Ozone" and "Ozone Therapy." Studies published between 2015 and 2023 that used any ozone formulation applied topically or systematically to patients with refractory ulcers were included. Results: Eight articles comprised the final sample of this study, with a higher frequency of randomized clinical trials (n: 7). The studies demonstrated the efficacy of ozone therapy in the treatment of refractory ulcers, improving healing, reducing pain, and inflammation. The therapy also showed a decrease in wound size, accelerated recovery, reduced infections, and minimized the need for amputation, improving patients' quality of life. Final considerations: The review revealed that ozone therapy is effective in treating refractory ulcers, but further research is needed to establish specific clinical guidelines. Future studies should address dosage, duration, and therapeutic combinations, considering the limitations of this integrative review.
References
AMELI J, et al. Mechanisms of pathophysiology of blood vessels in patients with multiple sclerosis treated with ozone therapy: a systematic review. Acta Biomed. 2019; 90(3): 213-217.
ANZALI BC, et al. Healing refractory diabetic foot ulcers (DFUs) by ozone therapy and silver dressing: A case report. Int J Surg Case Rep, 2023; 105: 107970.
ANZOLIN AP, et al. Ozonioterapia como terapêutica integrativa no tratamento da osteoartrose: uma revisão sistemática. BrJP, 2018; 1(2): 171-175.
BOCCI V, et al. An integrated medical treatment for type‐2 diabetes. Diabetes Metab Syndr. 2014; 8(1): 57‐61.
BRASIL. Ministério da Saúde (MS). Lei no 9.610, de 19 de fevereiro de 1998, que altera, atualiza e consolida a legislação sobre direitos autorais e dá outras providências. Diário Oficial da União. Brasília: Ministério da Saúde, 1998.
BRASIL. Ministério da Saúde (MS). Portaria nº 702, de 21 de março de 2018. Diário Oficial da União, Brasília, DF, 2018.
FITZPATRICK E, et al. Ozone therapy for the treatment of chronic wounds: a systematic review. Int Wound J. 2018; 15(4): 633‐644.
FRYKBERG RG, et al. Challenges in the treatment of chronic wounds. Adv. Wound Care. 2015; 4: 560-582.
GIRONDI JBR, et al. Ozonioterapia no tratamento de feridas em adultos: revisão integrativa. Brazilian Journal of Development, 2021; 7(7): 68912-68925.
GOMES GVA, et al. Principais fatores de risco para mortalidade de longo prazo em pacientes com úlceras de pé diabético. Revista Eletrônica Acervo Saúde, 2023; 23(4): e12620.
GUO S, et al. Factors Affecting Wound Healing. J Dent Res, 2010; 89(3): 219-229.
INCHINGOLO F, et al. Successful use of a topical mixture with ozolipoile in the treatment of actinic ulcers. Clin Cosmet Investig Dermatol, 2015; 8: 147‐150.
IZADI M, et al. Efficacy of comprehensive ozone therapy in diabetic foot ulcer healing. Diabetes Metab Syndr. 2019; 13(1): 822‐825.
HASSANIEN M, et al. Non‐invasive oxygen‐ozone therapy in treating digital ulcers of patients with systemic sclerosis. Acta Reumatol Port, 2018; 43(3): 210‐216.
Hu X, et al. Combination of Negative Pressure Wound Therapy Using Vacuum‐Assisted Closure and Ozone Water Flushing for Treatment of Diabetic Foot Ulcers. Ctries: Int. J. Diabetes Dev, 2019.
LIU J, et al. Ozone therapy for treating foot ulcers in people with diabetes. Cochrane Database Syst Rev. 2015; 10: Cd008474.
MCHUGH ML. Interrater reliability: the kappa statistic. Biochemia Medica, 2012; 22(3): 276-282.
NUSSBAUM SR, et al. An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds. Value in Health, 2018; 21(1): 27-32.
PEREIRA AS, et al. Metodologia da pesquisa científica. (1ª ed.): UFSM, NTE, 2018.
SMITH NL, et al. Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility. Med Gas Res. 2017; 7(3): 212‐219.
SOUZA MT, et al. Integrative review: what is it? How to do it? Einstein (São Paulo), 2010; 8(1): 102-106.
PIRES JR, et al. Efeito da terapia sistêmica de ozônio como um biomodulador da regeneração tecidual e da resposta inflamatória em ratos. Rev. Odontol. UNESP, 2021; 50: e20210046.
RANGWALA US, et al. The Potential of Topical Therapy for Diabetic Wounds: A Narrative Review. Cureus. 2023; 15(3): e36887.
SEN CK, et al. Human Skin Wounds: A Major and Snowballing Threat to Public Health and the Economy. Wound Repair Regen, 2009; 17(6): 763–771.
SERRA MAG, et al. The role of ozone treatment as integrative medicine. An evidence and gap map. Front Public Health, 2023; 10: 1112296.
SOLOVĂSTRU LG, et al. Randomized, controlled study of innovative spray formulation containing ozonated oil and α‐bisabolol in the topical treatment of chronic venous leg ulcers. Adv Skin Wound Care, 2015; 28(9): 406‐409.
STILLWELL S, et al. Evidence– based practice: step by step. Am J Nurs, 2010; 110(5): 41-47.
TARDÁGUILA-GARCÍA A, et al. Utility of Blood Parameters to Detect Complications during Long-Term Follow-Up in Patients with Diabetic Foot Osteomyelitis. J Clin Med., 2020; 9(11): 3768.
UZUN G, et al. Pitfalls of Intralesional ozone injection in diabetic foot ulcers: a case study. J Am Coll Clin Wound Spec. 2012; 4(4): 81‐83.
XINYUAN QWL, et al. Ozone bath in the treatment of diabetic foot ulcer infection. Chin J Tissue Eng Res, 2020; 24(17): 2735‐2741.
WEN Q, et al. Effects of ozone for treating chronically refractory wounds and ulcers: A protocol for systematic review and meta-analysis of randomized clinical trials. Medicine (Baltimore), 2020; 99(22): e20457.
ZHANG J, et al. Increased growth factors play a role in wound healing promoted by noninvasive oxygen‐ozone therapy in diabetic patients with foot ulcers. Oxidative Med Cell Longev., 2014; 2014: 273475.
ZHOU YT, et al. Ozone gas Bath combined with Endovenous laser therapy for lower limb venous ulcers: a randomized clinical trial. J Investig Surg, 2016; 29(5): 254‐259.