Benefits of Ozone Use in Wound Healing

Abstract

Objective: The treatment of chronic wounds represents a significant challenge for public health, as these lesions fail to follow the natural healing process, evolving with infection, hypoxia, and molecular alterations that perpetuate the inflammatory state. Therefore, this study aimed to analyze the scientific evidence on the efficacy of ozone therapy in the healing process of chronic skin lesions and to elucidate its mechanisms of action. For this purpose, an integrative literature review was conducted in the PubMed, Virtual Health Library (VHL), and LILACS databases. Seven studies published between 2022 and 2025 comprised the final sample. The results demonstrated that ozone therapy acts through antimicrobial, immunomodulatory, antioxidant, and angiogenic mechanisms, with the activation of the NRF2 pathway and inhibition of NF-κB identified as central to reducing pro-inflammatory cytokines and promoting a favorable cellular environment. Synergistic use with antibiotics proved effective against biofilms, and combination with scaffolds and mesenchymal stem cells enhanced tissue regeneration. Clinically, the therapy was associated with better glycemic control, reduction in wound area, and a lower amputation rate. In conclusion, ozone therapy is a promising complementary strategy; however, there is still a scarcity of robust clinical trials and standardized protocols.