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Ye S, Jin N, Liu N, Cheng F, Hu L, Zhang G, Li Q, Jing J. Gases and gas-releasing materials for the treatment of chronic diabetic wounds. Biomater Sci 2024; 12:3273-3292. [PMID: 38727636 DOI: 10.1039/d4bm00351a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Chronic non-healing wounds are a common consequence of skin ulceration in diabetic patients, with severe cases such as diabetic foot even leading to amputations. The interplay between pathological factors like hypoxia-ischemia, chronic inflammation, bacterial infection, impaired angiogenesis, and accumulation of advanced glycosylation end products (AGEs), resulting from the dysregulation of the immune microenvironment caused by hyperglycemia, establishes an unending cycle that hampers wound healing. However, there remains a dearth of sufficient and effective approaches to break this vicious cycle within the complex immune microenvironment. Consequently, numerous scholars have directed their research efforts towards addressing chronic diabetic wound repair. In recent years, gases including Oxygen (O2), Nitric oxide (NO), Hydrogen (H2), Hydrogen sulfide (H2S), Ozone (O3), Carbon monoxide (CO) and Nitrous oxide (N2O), along with gas-releasing materials associated with them have emerged as promising therapeutic solutions due to their ability to regulate angiogenesis, intracellular oxygenation levels, exhibit antibacterial and anti-inflammatory effects while effectively minimizing drug residue-induced damage and circumventing drug resistance issues. In this review, we discuss the latest advances in the mechanisms of action and treatment of these gases and related gas-releasing materials in diabetic wound repair. We hope that this review can provide different ideas for the future design and application of gas therapy for chronic diabetic wounds.
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Affiliation(s)
- Shuming Ye
- Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
| | - Neng Jin
- Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
| | - Nan Liu
- Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
| | - Feixiang Cheng
- Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
| | - Liang Hu
- Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
| | - Guiyang Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, China.
| | - Qi Li
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
| | - Juehua Jing
- Department of Orthopaedics, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
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Talebi HM, Javaheri J, Fakhari MS. Successful treatment of a high-risk diabetic foot ulcer by ozone therapy and collagen powder: A case report. Clin Case Rep 2024; 12:e8728. [PMID: 38562577 PMCID: PMC10983709 DOI: 10.1002/ccr3.8728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Key Clinical Message A high risk diabetic foot ulcer is treated by ozone therapy and collagen powder. The goal of this study was to report a high risk case, treated by ozone therapy, and collagen powder. Ozone therapy and collagen powder can improve healing process of diabetic foot ulcers. Abstract This case report presents a successful nonsurgical outpatient approach for managing a high-risk diabetic foot ulcer with tendon exposure in an older adult with uncontrolled diabetes mellitus and severe heart failure. Due to the patient's comorbidities, surgical intervention was not an option, leading to the utilization of ozone therapy, collagen powder, and Phenytoin ointment. The significance of this case lies in the treatment of a high-risk foot ulcer through a nonsurgical approach, considering the patient's uncontrolled diabetes and severe heart failure. Diabetic foot ulcers (DFUs) are debilitating and life-threatening complications, often resulting in amputations, socio-psychological burdens, and lifestyle changes. Conventional treatment methods have shown limited success, necessitating the exploration of new and innovative approaches. The use of ozone therapy has emerged as a potential treatment, but its safety and efficacy in DFUs require further investigation. The positive outcomes observed in this case report suggest that ozone therapy may be a viable option for treating DFUs, and further studies are recommended to evaluate its effectiveness.
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Affiliation(s)
| | - Javad Javaheri
- Department of Health and Community MedicineArak University of Medical SciencesArakMarkazi ProvinceIran
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Sun H, Heng H, Liu X, Geng H, Liang J. Evaluation of the healing potential of short-term ozone therapy for the treatment of diabetic foot ulcers. Front Endocrinol (Lausanne) 2024; 14:1304034. [PMID: 38292773 PMCID: PMC10825947 DOI: 10.3389/fendo.2023.1304034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024] Open
Abstract
Background The availability of research on short-term ozone therapy for diabetic foot ulcers (DFUs) is limited, and even when it is accessible, it mainly comprises of basic analysis conducted during long-term ozone therapy. This study was to evaluate the efficacy of short-term ozone therapy in promoting wound healing in DFUs. Methods A retrospective analysis was conducted on 89 patients with type 2 diabetes complicated by DFUs. The patients were divided into two groups: ozone therapy group (n=41) and control group (n=48). Wound condition, change of bacterial types, changes in inflammatory indicators (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], and procalcitonin [PCT]), vascular endothelial growth factor (VEGF), cytokines [Interleukin 6 (IL-6) and tumor necrosis factor-α(TNF-α)], and oxidative stress levels (superoxide dismutase [SOD], malondialdehyde [MDA], and total antioxidant capacity [T-AOC]) were observed pre-treatment and after 1 week. After a 12-week of follow-up, wound healing rate, amputation rate, inpatient day, duration of antibiotics, reinfection rate, incidence of new ulcers, readmission rate, and reoperation rate, and cumulative wound healing rate using Kaplan-Meier curves were assessed. Results After 1 week of treatment, the ozone therapy group showed higher VEGF, SOD, and T-AOC levels compared to the control group (P<0.05), while CRP, PCT, ESR, IL-6, TNF-α, MDA levels and bacterial types were lower (P<0.05). The ozone therapy group had a higher wound healing rate after a 12-week follow-up (P<0.05). Kaplan-Meier curves indicated a higher cumulative wound healing rate in the ozone therapy group (P<0.05). Additionally, the ozone therapy group had lower inpatient day, duration of antibiotics, reinfection rate, and readmission rate compared to the control group (P<0.05). Conclusion Short-term ozone therapy is effective in promoting wound healing in DFUs by reducing inflammation, increasing growth factor levels, improving oxidative stress status, shortening healing time, and improving long-term prognosis. These findings suggest the potential of short-term ozone therapy as a valuable treatment modality for DFUs.
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Affiliation(s)
| | | | | | - Houfa Geng
- Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China
| | - Jun Liang
- Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China
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Izadi M, Jafari-Oori M, Eftekhari Z, Jafari NJ, Maybodi MKE, Heydari S, Vahedian-Azimi A, Atkin SL, Jamialahmadi T, Sahebkar A. Effect of Ozone Therapy on Diabetes-related Foot Ulcer Outcomes: A Systematic Review and Meta-analysis. Curr Pharm Des 2024; 30:2152-2166. [PMID: 38982924 DOI: 10.2174/0113816128302890240521065453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/26/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE This study aimed to assess the effectiveness of ozone therapy in treating Diabetes-related Foot Ulcer (DFU) and its outcomes. METHODS A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and ProQuest databases for published studies evaluating the use of ozone as an adjunct treatment for DFU, from inception to December 21, 2022. The primary outcome measure was the change in wound size after the intervention compared to pretreatment. Secondary outcomes included time to complete ulcer healing, number of healed patients, adverse events, amputation rates, and hospital length of stay. Quantitative data synthesis for the meta-analysis was performed using a random-effects model and generic inverse variance method, while overall heterogeneity analysis was conducted using a fixed-effects model. Interstudy heterogeneity was assessed using the I2 index (>50%) and the Cochrane Q statistic test. Sensitivity analysis was performed using the leave-one-out method. RESULTS The meta-analysis included 11 studies comprising 960 patients with DFU. The results demonstrated a significant positive effect of ozone therapy on reducing foot ulcer size (Standardized Mean Difference (SMD): -25.84, 95% CI: -51.65 to -0.04, p = 0.05), shortening mean healing time (SMD: -38.59, 95% CI: -51.81 to -25.37, p < 0.001), decreasing hospital length of stay (SMD: -8.75, 95% CI: -14.81 to -2.69, p < 0.001), and reducing amputation rates (Relative Risk (RR): 0.46, 95% CI: 0.30-0.71, p < 0.001), compared to standard treatment. CONCLUSION This meta-analysis indicates that ozone therapy has additional benefits in expediting complete DFU healing, reducing the amputation rates, and decreasing hospital length of stay, though its effects do not differ from standard treatments for complete ulcer resolution. Further research is needed to address the heterogeneity among studies and to better understand the potential beneficial effects of ozone therapy.
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Affiliation(s)
- Morteza Izadi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mehdi Jafari-Oori
- Faculty of Nursing, Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Zohre Eftekhari
- Biotechnology Department, Pasteur Institute of Iran, Tehran, Iran
| | - Nematollah Jonaidi Jafari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Soleyman Heydari
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Nursing Faculty, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Stephen L Atkin
- Royal College of Surgeons in Ireland-Bahrain, Adliya, Manama, Kingdom of Bahrain
| | - Tannaz Jamialahmadi
- International UNESCO Center for Health-related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Chirumbolo S, Valdenassi L, Tirelli U, Pandolfi S, Franzini M. The use of the medical ozone in the immune challenge of multidrug resistant (MDR) bacteria and the role of mitochondria. Microbes Infect 2024; 26:105242. [PMID: 38380603 DOI: 10.1016/j.micinf.2023.105242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 02/22/2024]
Affiliation(s)
| | - Luigi Valdenassi
- Italian Scientific Society in Oxygen Ozone Therapy (SIOOT), Bergamo, Italy
| | | | - Sergio Pandolfi
- Italian Scientific Society in Oxygen Ozone Therapy (SIOOT), Bergamo, Italy
| | - Marianno Franzini
- Italian Scientific Society in Oxygen Ozone Therapy (SIOOT), Bergamo, Italy.
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Astasio-Picado Á, Babiano AÁ, López-Sánchez M, Lozano RR, Cobos-Moreno P, Gómez-Martín B. Use of Ozone Therapy in Diabetic Foot Ulcers. J Pers Med 2023; 13:1439. [PMID: 37888050 PMCID: PMC10608575 DOI: 10.3390/jpm13101439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION ozone therapy is a therapy composed of ozone. This gas is in the atmosphere with various general effects: direct disinfectant and trophic effects and a systemic antibacterial and antiviral effect. This gas also improves blood circulation, makes glucose metabolism more effective, improves erythrocyte metabolism, and improves fatty acid metabolism. OBJECTIVE Provide evidence of the effectiveness of ozone therapy in wounds of patients with diabetic foot. Analyze the effectiveness of ozone therapy compared to other treatments to achieve good wound healing in patients with diabetic foot. To study the benefits of the use of ozone therapy in ulcers of patients. Analyze the management of ozone therapy and other treatments to achieve healing of ulcers in patients. METHODOLOGY A bibliographic review focused on articles published between November 2014 and June 2023 was carried out. The following databases were consulted: Pubmed (Medline), Dialnet, Google Scholar, Web of Science (WOS), Scielo, and Scopus. RESULTS After applying the article selection criteria and evaluating the quality of the methodology, a total of 17 articles were obtained. The results affirm ozone therapy as promising for the treatment of wounds in patients with diabetic foot. CONCLUSIONS the evidence has been able to determine that ozone therapy is adequate for the treatment of diabetic foot ulcers. In addition, the therapy has been shown to be effective, safe, and beneficial, with few adverse effects for the treatment of diabetic foot ulcers.
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Affiliation(s)
- Álvaro Astasio-Picado
- Physiotherapy, Nursing and Physiology Department, Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Toledo, Spain;
| | - Alba Ángel Babiano
- Physiotherapy, Nursing and Physiology Department, Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Toledo, Spain;
| | | | - Rocio Ruiz Lozano
- Extremadura Health Service, 10300 Cáceres, Spain; (M.L.-S.); (R.R.L.)
| | - Paula Cobos-Moreno
- Nursing Department, University of Extremadura, Plasencia (Cáceres), 10600 Plasencia, Spain; (P.C.-M.); (B.G.-M.)
| | - Beatriz Gómez-Martín
- Nursing Department, University of Extremadura, Plasencia (Cáceres), 10600 Plasencia, Spain; (P.C.-M.); (B.G.-M.)
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Anzali BC, Goli R, Torabzadeh A, Kiani A, Rasouli M, Balaneji SM. Healing refractory diabetic foot ulcers (DFUs) by ozone therapy and silver dressing: A case report. Int J Surg Case Rep 2023; 105:107970. [PMID: 36924601 PMCID: PMC10025974 DOI: 10.1016/j.ijscr.2023.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Refractory diabetic foot ulcers (DFUs) are still a major health problem and can lead to death. CASE PRESENTATION The present case reports a 45-year-old man with an 8-year history of type 2 diabetes who has had left refractory DFU for a year on the left heel with a size of 6 × 3 × 1 cm. The patient's ulcers were infected with Staphylococcus aureus. Despite the routine DFU care (normal saline dressing twice a day and intravenous antibiotic therapy), the patient did not recover from DFU using standard methods. The patient was referred to our wound management team. In the first step, the necrotic tissues of his foot ulcer were irrigated and debrided using mechanical debridement and saline. Next, the patient underwent a 70 μg/dL dose of ozone therapy over a 30-day period in 10 sessions (one 20-minute session every 3 days). Between each session, the patient's wound was wrapped in silver-containing gauze bandages. After two months, the patient's DFUs healed, and he was discharged from our service in good condition. CLINICAL DISCUSSION DFU can lead to infection, amputation, and even patient death. Therefore, effective treatment methods are very important for managing DFUs. CONCLUSION This case report study was shown that the ozone therapy is an effective approach to improve the healing of refractory DFUs and prevent foot amputation. Therefore, wound-care teams can utilize it as an adjunct to the standard methods of DFU treatment.
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Affiliation(s)
- Babak Choobi Anzali
- Department of Emergency Medicine, University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
| | - Aysan Torabzadeh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Arezou Kiani
- Assistant Professor of Pediatric Psychiatry, Urmia University of Medical Sciences, Urmia, Iran
| | - Mehran Rasouli
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad university of Zanjan, Zanjan, Iran
| | - Sahar Majidi Balaneji
- Department of Midwifery, School of Nursing and Midwifery, Islamic Azad university of Urmia, West Azerbaijan, Iran
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Rania V, Marcianò G, Casarella A, Vocca C, Palleria C, Calabria E, Spaziano G, Citraro R, De Sarro G, Monea F, Gallelli L. Oxygen-Ozone Therapy in Cervicobrachial Pain: A Real-Life Experience. J Clin Med 2022; 12:jcm12010248. [PMID: 36615046 PMCID: PMC9820947 DOI: 10.3390/jcm12010248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/12/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
This prospective, open-label clinical study was carried out to evaluate both the efficacy and safety of intramuscular paravertebral injections of an oxygen−ozone (O2−O3) mixture in patients with cervicobrachial pain. We enrolled 540 subjects affected by cervicobrachial pain referred to the Ozone Therapy Ambulatory at the Mater Domini Hospital of Catanzaro (Italy) and to the Center of Pain in Taurianova (Reggio Calabria, Italy). All the subjects (n = 540) completed the treatment and the follow-up visits. The subjects received a mean of 11 cervical intramuscular treatments with an O2−O3 mixture (5 mL) with an O3 concentration of 10 μg/mL bis a week. The improvement of pain was measured by a change in the mean of the Visual Analog Scale (VAS) score from baseline to the end of treatment and during follow-ups. Patient satisfaction was assessed at the end of treatment using the SF-36 Questionnaire. The development of adverse drug reactions was recorded. The mean (±standard deviation) VAS pain score at baseline, at the end of treatment, and during follow-ups showed a significant reduction in pain over time (p < 0.001). All the patients who were enrolled (n: 540) were pain-free after one year. According to the pain distribution, all subjects showed a significant reduction in pain over time in each group (p < 0.05). No significant differences were observed with respect to sex or age. No adverse events were observed during the study. In conclusion, we documented that the intramuscular injection of an O2−O3 mixture is an effective and safe treatment option for patients with cervicobrachial pain.
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Affiliation(s)
- Vincenzo Rania
- Operative Unit of Pharmacology and Pharmacovigilance, “Mater Domini” Hospital, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Gianmarco Marcianò
- Operative Unit of Pharmacology and Pharmacovigilance, “Mater Domini” Hospital, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alessandro Casarella
- Operative Unit of Pharmacology and Pharmacovigilance, “Mater Domini” Hospital, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Cristina Vocca
- Operative Unit of Pharmacology and Pharmacovigilance, “Mater Domini” Hospital, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Caterina Palleria
- Operative Unit of Pharmacology and Pharmacovigilance, “Mater Domini” Hospital, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
- Research Center FAS@UMG, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Elena Calabria
- Dentistry Unit, Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Giuseppe Spaziano
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
| | - Rita Citraro
- Operative Unit of Pharmacology and Pharmacovigilance, “Mater Domini” Hospital, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
- Research Center FAS@UMG, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Giovambattista De Sarro
- Operative Unit of Pharmacology and Pharmacovigilance, “Mater Domini” Hospital, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
- Research Center FAS@UMG, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Francesco Monea
- Poliambulatorio Specialistico, Taurianova, 89029 Reggio Calabria, Italy
| | - Luca Gallelli
- Operative Unit of Pharmacology and Pharmacovigilance, “Mater Domini” Hospital, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
- Research Center FAS@UMG, Department of Health Science, University “Magna Graecia”, 88100 Catanzaro, Italy
- GalaScreen Laboratories, University of Calabria, Ed. Polifunzionale, Arcavacata di Rende, 87036 Rende, Italy
- Medifarmagen SRL, University of Catanzaro and Mater Domini University Hospital, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-0961712322
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Li W, Wang QY, Bai XG, Xu J. Autologous platelet-rich gel in the treatment of diabetic foot ulcers: A retrospective study. Medicine (Baltimore) 2022; 101:e31701. [PMID: 36401364 PMCID: PMC9678626 DOI: 10.1097/md.0000000000031701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
This study retrospectively investigated the effectiveness and safety of autologous platelet-rich gel (APRG) for the treatment of diabetic foot ulcers (DFU). In this retrospective study, we reviewed the electronic medical records (EMR) of 72 patients with DFU. The patients were allocated to a treatment group (n = 36) or a control group (n = 36). The patients in both groups received standard care (SC) and dressing change. In addition, patients in the treatment group also received APRG. Patients in both groups were treated for 12 weeks. The outcomes were DFU healing time (days), length of hospital stay (days), healing rate of DFU, DFU surface area reduction (cm2), and adverse events. We assessed and analyzed the outcomes before and after the 12-week treatment period. After treatment, there were significant differences in DFU healing time (P = .04), length of hospital stay (P = .04), DFU healing rate, and DFU surface area reduction (P < .01). Regarding safety, no EMR reported adverse events in this study. The results of this study showed that the APRG may benefit patients with DFU. However, high-quality prospective randomized controlled trials are required to verify these findings.
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Affiliation(s)
- Wei Li
- Department of Endocrine and Metabolism, Yanan University Affiliated Hospital, Yan’an, China
| | - Qiao-Yun Wang
- Department of Ultrasound Diagnosis, Yanan University Affiliated Hospital, Yan’an, China
| | - Xiao-Gang Bai
- Department of Endocrine and Metabolism, Yanan University Affiliated Hospital, Yan’an, China
| | - Jie Xu
- Department of Endocrine and Metabolism, Yanan University Affiliated Hospital, Yan’an, China
- *Correspondence: Jie Xu, Department of Endocrine and Metabolism, Yanan University Affiliated Hospital, No. 43 North Street, Baota District, Yan’an, 716000, China (e-mail: )
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Bomfim TL, Gomes IA, Meneses DDVC, Araujo AADS. Effectiveness of Ozone Therapy as an Adjunct Treatment for Lower-Limb Ulcers: A Systematic Review. Adv Skin Wound Care 2021; 34:1-9. [PMID: 34546208 DOI: 10.1097/01.asw.0000789064.09407.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of topical ozone therapy as an adjuvant treatment in the healing of lower limb ulcers through a systematic literature review. DATA SOURCES Three databases were used to search for studies conducted in the period up to and including September 2020: PubMed, Scopus, and the Web of Science. STUDY SELECTION The search identified 44 studies, 7 of which met the eligibility criteria and were evaluated. DATA EXTRACTION Study design, study location, number of patients, patient age, type of control, wound type, intervention type, equipment used to generate ozone (ozone generation), evaluation methodology, and main results were extracted from each study. DATA SYNTHESIS A total of 506 patients 18 years or older with chronic wounds, such as venous or diabetic ulcers, on the lower limbs were enrolled. The majority of studies addressed diabetic foot ulcers. CONCLUSIONS The ozone therapy protocols demonstrated a healing effect in all included studies, and none reported adverse effects. This reinforces the need for more controlled and randomized clinical trials to determine the effectiveness of this treatment and establish clinical criteria for its use.
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Affiliation(s)
- Tássia Lima Bomfim
- At the Fundação Universidade Federal de Sergipe, São Cristóvão, Brazil, Tássia Lima Bomfim, MSc, is Nurse, Wound Healing Outpatient Clinic, University Hospital; Isla Alcântara Gomes, MSc, is PhD Student, Pharmaceutical Sciences; Daniele de Vasconcelos Cerqueira Meneses, MSc, is Master's Student, Health Sciences; and Adriano Antunes de Souza Araujo, PhD, is Director, Center of Biological and Health Sciences. Acknowledgments: The authors thank the Conselho Nacional de Desenvolvimento Científico e Tecnológico/CNPq/Brazil and Fundação de Amparo à Pesquisa do Estado de Sergipe/FAPITEC-SE for their financial support. The authors have disclosed no other financial relationships related to this article. Submitted March 22, 2021; accepted in revised form May 10, 2021
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Faraji N, Goli R, Choobianzali B, Bahrami S, Sadeghian A, Sepehrnia N, Ghalandari M. Ozone therapy as an alternative method for the treatment of diabetic foot ulcer: a case report. J Med Case Rep 2021; 15:234. [PMID: 33980300 PMCID: PMC8117654 DOI: 10.1186/s13256-021-02829-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/26/2021] [Indexed: 01/17/2023] Open
Abstract
Background Diabetic foot ulcer (DFU) is one of the most important complications of diabetes that can lead to amputation. Treatment of DFUs is a major challenge and places a heavy economic and social burden on patients and their families. Case presentation The present case report is of a 52-year-old kurdish male patient with a 7-year history of type 2 diabetes. While on a bike ride, he sustained a traumatic injury to his right leg, which caused a deep gash measuring 14 × 5 cm on the tibia. During the hospital stay, no improvement was observed after routine wound care including suturing, antibiotic therapy, and dressing change. The patient was referred to our wound-care team. In the first step, the necrotic tissues of his foot ulcer were irrigated and then debrided using mechanical debridement and saline. Next, the patient underwent a 70 μg/dL dose of ozone therapy over a 30-day period in 10 sessions (one 20-minute session every 3 days). Between each session, the patient's wound was wrapped in silver-containing gauze bandages. After 1 month of wound-care using ozone therapy, the patient's foot ulcer had healed and he was discharged from our wound-care service with a stable and good general condition. Conclusion Considering the effectiveness of ozone therapy along with silver-containing dressing in the treatment of DFUs, wound-care teams can utilize it as an adjunct to the standard methods of DFU treatment.
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Affiliation(s)
- Navid Faraji
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111, Urmia, West Azerbaijan, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111, Urmia, West Azerbaijan, Iran.
| | - Babak Choobianzali
- Department of Emergency Medicine, Medicine Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111, Urmia, West Azerbaijan, Iran
| | - Soheyla Bahrami
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Islamic Azad University of BonaB Branch, Velayat Highway, 555178-5176, Bonab, East Azerbaijan, Iran
| | - Ali Sadeghian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Dr.Sobouti Blvd., 451395-6111, Zanjan, Iran
| | - Nazila Sepehrnia
- Department of Psychiatric Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Shahnaz Street, 575611-5111, Tabriz, East Azerbaijan, Iran
| | - Mahmoodreza Ghalandari
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111, Urmia, West Azerbaijan, Iran
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de Sire A, Agostini F, Lippi L, Mangone M, Marchese S, Cisari C, Bernetti A, Invernizzi M. Oxygen-Ozone Therapy in the Rehabilitation Field: State of the Art on Mechanisms of Action, Safety and Effectiveness in Patients with Musculoskeletal Disorders. Biomolecules 2021; 11:biom11030356. [PMID: 33652804 PMCID: PMC7996934 DOI: 10.3390/biom11030356] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/11/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
In recent years, the interest in oxygen–ozone (O2O3) therapy application has considerably increased in the field of rehabilitation. Despite its widespread use in common clinical practice, the biochemical effects of O2O3 are still far from being understood, although its chemical properties seem to play a pivotal role in exerting its positive effects on different pathological conditions. Indeed, the effectiveness of O2O3 therapy might be partly due to the moderate oxidative stress produced by O3 interactions with biological components. O2O3 therapy is widely used as an adjuvant therapeutic option in several pathological conditions characterized by chronic inflammatory processes and immune over-activation, and most musculoskeletal disorders share these pathophysiological processes. The present comprehensive review depicts the state-of-the-art on the mechanisms of action, safety and effectiveness of O2O3 therapy in the complex scenario of the management of musculoskeletal disorders. Taken together, our findings suggest that O2O3 therapy seems to reduce pain and improve functioning in patients affected by low back pain and knee osteoarthritis, as reported by several studies in the literature. However, to date, further studies are warranted to clearly investigate the therapeutic effects of this promising therapy on other musculoskeletal disorders in the field of rehabilitation.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-096-136-9768
| | - Francesco Agostini
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (C.C.); (M.I.)
| | - Massimiliano Mangone
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Simone Marchese
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Carlo Cisari
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (C.C.); (M.I.)
| | - Andrea Bernetti
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (C.C.); (M.I.)
- Infrastruttura Ricerca Formazione Innovazione (IRFI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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