Ozone therapy as a treatment for diabetic foot ulcers: a systematic review and meta-analysis.

IF 1.5 4区医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-12-02 DOI:10.12968/jowc.2022.0189

Markinokoff Lima E Silva Filho, André Oliveira Paggiaro, Viviane Fernandes de Carvalho, Rolf Gemperli

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Abstract

Objective: Studies have suggested that ozone therapy stimulates antioxidant enzyme expression and activity, regulates growth factor production, increases local blood flow and provides antibacterial protection. We sought to analyse the evidence related to the use of ozone therapy in the treatment of diabetic foot ulcers (DFUs).

Method: A systematic review and meta-analysis was conducted using published clinical trials indexed in the PubMed, Embase and Web of Science databases up to December 2020. Outcomes analysed included: number of ulcers cured; ulcer area reduction; length of hospital stay; changes in blood glucose levels; antioxidant activity; and number of amputations.

Results: Initially, 61 studies were identified; however, only six met all of the eligibility criteria for inclusion in the final sample. It was found that patients receiving ozone therapy displayed higher rates of healing (i.e., healed ulcers), shorter hospital stays, increased catalase activity and reduced blood glucose levels. There was an observed increase in the number of ulcers healed; however, there was a considerable risk of bias in the studies evaluated.

Conclusion: Although many studies have suggested ozone therapy as a promising candidate in the treatment of DFUs, further research is required, with a better scientific outline, to validate the results.

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臭氧治疗糖尿病足溃疡：一项系统综述和荟萃分析。

目的：研究表明，臭氧治疗刺激抗氧化酶的表达和活性，调节生长因子的产生，增加局部血流量并提供抗菌保护。我们试图分析臭氧治疗糖尿病足溃疡（DFUs）的相关证据。方法：对截至2020年12月PubMed、Embase和Web of Science数据库中已发表的临床试验进行系统回顾和荟萃分析。分析的结果包括：溃疡治愈的数量；减少溃疡面积；住院时间；血糖水平的变化；抗氧化活性;以及截肢的数量。结果：最初，确定了61项研究；然而，只有6人符合纳入最终样本的所有资格标准。研究发现，接受臭氧治疗的患者表现出更高的愈合率（即溃疡愈合）、更短的住院时间、过氧化氢酶活性增加和血糖水平降低。溃疡愈合的数量明显增加；然而，在评估的研究中存在相当大的偏倚风险。结论：虽然许多研究表明臭氧疗法是治疗DFUs的一种有希望的候选方法，但需要进一步的研究，以更好的科学大纲来验证结果。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.