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      Liquid ozone therapies for the treatment of epithelial wounds: A systematic review and meta‐analysis

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          Abstract

          Ozonated water and ozonated oils are emerging as potential therapies for wound care, but their efficacy has not been appropriately evaluated. The aim of this systematic review and meta‐analysis was to evaluate the therapeutic potential of topical ozone in the treatment of mammalian wounds. A structured search of five scientific databases returned a total of 390 unique studies. Of these, 22 studies were included in this review. Four studies provided enough data to be included in a meta‐analysis evaluating the time to complete wound healing. All studies were randomised controlled trials of humans or other mammalian animals that reported clinical signs of wound healing. Each study was critically analysed by a six‐point assessment of the risk of bias. Wounds treated with topical ozone had a greater reduction in wound size than similar wounds treated with controls or standard of care in all studies. Those treated with ozonated liquids also had a shorter time to wound healing by approximately one week. In conclusion, topical ozone contributed to enhanced wound healing in all studies. While additional human experiments would be helpful to quantify ozone's specific effects on wound healing compared to standard treatment, topical ozone should be considered as part of an overall wound management strategy.

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          Most cited references42

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          The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

          Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
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            An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds

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              Human Wound and Its Burden: Updated 2020 Compendium of Estimates.

              Significance: Chronic wounds impact the quality of life (QoL) of nearly 2.5% of the total population in the United States and the management of wounds has a significant economic impact on health care. Given the aging population, the continued threat of diabetes and obesity worldwide, and the persistent problem of infection, it is expected that chronic wounds will continue to be a substantial clinical, social, and economic challenge. In 2020, the coronavirus disease (COVID) pandemic dramatically disrupted health care worldwide, including wound care. A chronic nonhealing wound (CNHW) is typically correlated with comorbidities such as diabetes, vascular deficits, hypertension, and chronic kidney disease. These risk factors make persons with CNHW at high risk for severe, sometimes lethal outcomes if infected with severe acute respiratory syndrome coronavirus 2 (pathogen causing COVID-19). The COVID-19 pandemic has impacted several aspects of the wound care continuum, including compliance with wound care visits, prompting alternative approaches (use of telemedicine and creation of videos to help with wound dressing changes among others), and encouraging a do-it-yourself wound dressing protocol and use of homemade remedies/substitutions. Recent Advances: There is a developing interest in understanding how the social determinants of health impact the QoL and outcomes of wound care patients. Furthermore, addressing wound care in the light of the COVID-19 pandemic has highlighted the importance of telemedicine options in the continuum of care. Future Directions: The economic, clinical, and social impact of wounds continues to rise and requires appropriate investment and a structured approach to wound care, education, and related research.
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                Author and article information

                Contributors
                bleon@iu.edu
                Journal
                Int Wound J
                Int Wound J
                10.1111/(ISSN)1742-481X
                IWJ
                International Wound Journal
                Blackwell Publishing Ltd (Oxford, UK )
                1742-4801
                1742-481X
                03 September 2022
                April 2023
                : 20
                : 4 ( doiID: 10.1111/iwj.v20.4 )
                : 1235-1252
                Affiliations
                [ 1 ] School of Medicine Indiana University Indianapolis Indiana USA
                [ 2 ] Academic Health Center Pharmacy Indiana University Health Indianapolis Indiana USA
                Author notes
                [*] [* ] Correspondence

                Brian R. Leon, MD, FACP, 8040 Clearvista Dr. Suite 460, Indianapolis, IN 46256, USA.

                Email: bleon@ 123456iu.edu

                Author information
                https://orcid.org/0000-0002-6359-6927
                Article
                IWJ13941
                10.1111/iwj.13941
                10031250
                36056800
                4f479df1-1dde-4765-b6f4-67a7b853f0b8
                © 2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 13 August 2022
                : 19 May 2022
                : 14 August 2022
                Page count
                Figures: 8, Tables: 4, Pages: 18, Words: 7897
                Funding
                Funded by: 3Oe Scientific, Inc.
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                April 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.6 mode:remove_FC converted:22.03.2023

                Emergency medicine & Trauma
                dermatologic agent,efficacy,ozone,topical administration,wound healing
                Emergency medicine & Trauma
                dermatologic agent, efficacy, ozone, topical administration, wound healing

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