A systematic review of ozone therapy for treating chronically refractory wounds and ulcers
Wen Q, Liu D, Wang X, et al. International Wound Journal, 2022.
- Study type
- Systematic review / meta-analysis
- People studied
- Total not recorded
- Population
- People with chronic wounds and ulcers, mainly diabetic foot ulcers, pooled from 12 randomized trials
- Published
- 2022, International Wound Journal
- Identifiers
- PMID 34612569, DOI 10.1111/iwj.13687
What the authors reported
Pooling 12 randomized trials of topical or systemic ozone therapy for chronic wounds, this review found ozone accelerated wound-area improvement and reduced amputation rate for diabetic foot ulcers versus standard care, though complete wound healing rates and hospital stay did not differ, with no reported adverse events attributed to ozone across included studies.
What limits this result
Included trials varied widely in ozone delivery method and wound type; the authors state evidence for wound types other than diabetic foot ulcers remains uncertain due to insufficient studies.
Other ozone methods, such as major autohemotherapy, that clinics cite in support of EBO2. A result for one method does not transfer automatically to another. One study rarely settles a medical question; our guides weigh each paper against the rest of the evidence.
How the study was done
- Design
- Systematic review and meta-analysis, registered in INPLASY
- Setting
- Medical Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Read from
- Read from the full text of the paper. Read on September 28, 2026.
What it measured
- Included studies and how ozone was applied
- 12 included studies; topical application (ozone gas bath, ozonated oil, ozone water flushing) and systematic applications including autologous blood immunomodulation and rectal insufflation
- Diabetic foot ulcers: improvement of the wound area, ozone therapy versus standard control therapy
- Ozone therapy markedly accelerated the improvement of the wound area; standardised mean difference (SMD) = 66.54%
- Diabetic foot ulcers: amputation rate
- Reduced; risk ratio (RR) = 0.36
- Proportion of participants with completely healed wounds, and length of hospital stay
- No improvement
- Length of hospital stay (two studies)
- Not significantly different, ozone monotherapy or combined control treatment versus control group; SMD = −1.79
- Efficacy of ozone therapy for other wound types
- Still uncertain because of no sufficient studies
- Quality of reporting in included studies
- Overall, the quality of reporting was poor
Overall, the quality of reporting was poor because of insufficient formation obtainable in the literature.
- Authors' statement on judging the safety of ozone
- Not able to judge the safety of ozone as inadequate studies
Safety as reported
No adverse events associated with ozone treatment have been reported
Source: Abstract on PubMed
Funding and conflicts
Funding: the Sichuan Science and Technology Program, Grant/Award Number 2019YFS0085
Source: Full text on PubMed Central
Where we cite this study
Does EBO2 (EBOO) Work? The Evidence, Study by Study
Every study in our EBO2 (EBOO) library in one place: design, size, what was measured and found, its limits, and a check for any study a clinic cites.