OZONE TREATMENT AND AUXILIARY TREATMENT OF HEMORRHOIDS
Hydrogen peroxide (H₂O₂), commonly known as hydrogen peroxide, is a widely used disinfectant and debriding agent in healthcare settings due to its potent antimicrobial properties. Recently, medical research has shown promising results regarding the therapeutic potential of ozonated water, which contains dissolved ozone gas (O₃), in the management of chronic nonhealing wounds, particularly venous leg ulcers and pressure injuries. This review aims to provide scientific evidence on the efficacy and safety of topical ozonated water as both primary therapy and adjunctive treatment for wound healing.
Topical ozonated water has been found to exhibit superior antibacterial activity compared to H₂O₂ against a variety of pathogens, including Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Candida albicans, and Enterococcus faecalis. A study published in the Journal of Wound Ostomy & Continence Nurses Society demonstrated that ozonated water significantly reduced wound colonization rates of S. Aureus and P. Aeruginosa within seven days of application (P < .05). Additionally, ozonated water showed comparable efficacy to silver sulfadiazine dressing in reducing Gram-negative bacteria colony counts on diabetic foot ulcer wounds (P = .89).
The mechanism behind the effectiveness of ozonated water lies in its unique chemical structure. When ozone comes into contact with water, it rapidly converts into reactive oxygen species (ROS) and organic hydroperoxides (OPOs), which possess broad-spectrum antimicrobial properties through multiple mechanisms, such as oxidizing enzyme cofactors, damaging nucleotide bases, interfering with protein synthesis, and inducing lipid peroxidation. Furthermore, these ROS and OPPOs promote collagen production, angiogenesis, and granulation tissue formation, contributing to the overall wound healing process.
Another advantage of using ozonated water is its low toxicity profile. Unlike traditional disinfectants like alcohol, iodine, and acetic acid, ozonated water exhibits minimal cytotoxicity towards human keratinocytes and fibroblasts at therapeutic concentrations (0.5 - 1.0 mM). Moreover, ozonated water has been found to stimulate macrophage recruitment and activation, leading to enhanced phagocytosis and clearance of necrotic debris.
Clinical studies investigating the therapeutic benefits of topical ozonated water in wound care have yielded positive outcomes. In a randomized controlled trial comparing ozonated water versus saline solution as secondary intention healing agents for diabetic foot ulcers, researchers observed faster epithelization, less foul odor, lower infection rate, and higher subject satisfaction scores in the ozonated water group (P < .05). Similarly, another study evaluating the impact of ozonated water as an aid for surgical site cleaning prior to incision closure revealed statistically significant reductions in wound infection and revision surgery rates among patients treated with ozonated water (P = .013).
However, some limitations should be considered when applying ozonated water in clinical practice. Firstly, ozonated water solutions have relatively short shelf lives due to their high reactivity and instability; thus, they require refrigeration storage and daily preparation before each usage. Secondly, there exists a risk of hyperbaric oxygen toxicity if ozonated water is administered via irrigation catheters or large volumes. Therefore, caution must be exercised during the administration process and appropriate monitoring procedures implemented. Thirdly, the cost of ozonated water products may vary considerably depending on the manufacturer and country, which could potentially influence the affordability and accessibility of this modality for certain populations.
To summarize, topical ozonated water presents a promising alternative to conventional wound cleansers given its robust antimicrobial action, minimal cytotoxicity, and beneficial effects on tissue repair processes. However, further investigations are required to evaluate its long-term benefits and compare its efficacy with other advanced wound therapies such as negative pressure wound therapy and growth factor dressings. Future research could focus on optimizing the dosing regimen, developing novel methods of delivery, and exploring the synergistic potential of combining ozonated water with existing modalities. Overall, the utilization of ozonated water in wound care constitutes a valuable area of investigation for clinicians and researchers alike.
