Abstract
The prevalence of diabetic foot ulcers (DFUs) in India is 11.6%. DFU accounts for
major cost expenditure, morbidity, and mortality.[1 ] Ozone gas has antimicrobial and antioxidant properties. We studied efficacy of topical
ozone gas therapy in promoting healing of DFU. This is an observational comparative
cohort study, n = 160, There were two groups of patients namely: those who received Conventional
wound management alone C and those who received topical ozone therapy in addition
to conventional wound management O + C therapy groups (81 each). Study group, i.e.,
O + C received five alternate day sessions of ozone therapy by bagging method for
30 minutes each session. Both groups were observed for 30 days for wound healing parameters
like reduction of wound surface area, wound diameter, presence and character of discharge,
granulation tissue, healing wound edges, microbial negativity, and requirement of
revision (re-debridement and/or amputation) surgery. Mean baseline ulcer surface area
is 17.43 ± 8.6 cm2 for C and 17.87 ± 9.2 cm2 (range 1–50 cm2 ) in O + C group. Percentage change in ulcer surface after 21 days in O + C group
is 32.37% compared with 17.15% in C group, which is statistically significant (p = 0.01). Rates of microbial negativity and ulcer healing were significantly faster
in ozone group. There was a statistically significant decrease in hospital stay, number
of revision surgeries required, and mortality in ozone group. Topical ozone gas was
well tolerated. Our study supports the efficacy of ozone therapy in DFU healing and
reduction in the chances of infection and revision (re-debridement and/or amputation)
surgery. More research is needed for dose, duration, and exposure time standardization.
Keywords diabetic foot ulcers - topical ozone gas therapy - wound healing
