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


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          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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              Ozone therapy: A clinical review

              Ozone (O3) gas discovered in the mid-nineteenth century is a molecule consisting of three atoms of oxygen in a dynamically unstable structure due to the presence of mesomeric states. Although O3 has dangerous effects, yet researchers believe it has many therapeutic effects. Ozone therapy has been utilized and heavily studied for more than a century. Its effects are proven, consistent, safe and with minimal and preventable side effects. Medical O3 is used to disinfect and treat disease. Mechanism of actions is by inactivation of bacteria, viruses, fungi, yeast and protozoa, stimulation of oxygen metabolism, activation of the immune system. Medication forms in a gaseous state are somewhat unusual, and it is for this reason that special application techniques have had to be developed for the safe use of O3. In local applications as in the treatment of external wounds, its application in the form of a transcutaneous O3 gas bath has established itself as being the most practical and useful method, for example at low (sub-atmospheric) pressure in a closed system guaranteeing no escape of O3 into the surrounding air. Ozonized water, whose use is particularly known in dental medicine, is optimally applied as a spray or compress. Diseases treated are infected wounds, circulatory disorders, geriatric conditions, macular degeneration, viral diseases, rheumatism/arthritis, cancer, SARS and AIDS.

                Author and article information

                Int Wound J
                Int Wound J
                International Wound Journal
                Blackwell Publishing Ltd (Oxford, UK )
                03 September 2022
                April 2023
                : 20
                : 4 ( doiID: 10.1111/iwj.v20.4 )
                : 1235-1252
                [ 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
                © 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.

                : 13 August 2022
                : 19 May 2022
                : 14 August 2022
                Page count
                Figures: 8, Tables: 4, Pages: 18, Words: 7897
                Funded by: 3Oe Scientific, Inc.
                Review Article
                Review Articles
                Custom metadata
                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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