Background & Aims

Skin lesions caused by burns are the result of various circumstances, capable of damaging epithelial tissues, causing cell death, pain and sometimes infection. It is essential to identify the degree of the burn according to the depth and extent of the affected area, so that the best therapy can be defined¹. Pain is a sign that is present and sometimes even neglected, as it is believed to be part of a burn patient’s symptoms, which is a challenge to care for. In this sense, there is medical ozone (O³) obtained from the conversion of pure oxygen using ozone generators²,3. Its therapeutic effects include: antimicrobial action, modulation of inflammation and promotion of analgesia, tissue regeneration, regulation of cellular metabolism, modulation of the immune system, disinfection and increased antioxidant activity of the blood4. The objective of this study was to describe the use of transcutaneous ozone therapy as an adjunct to pain management in patients with thermal burns.

Methods

Case series followed up at a teaching hospital in Brazil 2021. After applying discontinuity criteria three men aged 46, 26 and 58 with partial-depth burns, followed up weekly at the hospital outpatient clinic. Case 1, injury caused by a domestic accident on the left lower limb, pain 9 (Analog Pain Scale), with an area of 770cm², a large amount of serous exudate, friable granulation tissue, edema and perilesional maceration. Case 2, cause of accident with flames of fire in the hands, pain 9, left hand lesion 5.25cm² and 5.5cm² in the right hand, medium serous-purulent exudate, odor, perilesional maceration. Case 3, high-voltage burn on the face and upper limbs, intense pain 10, large seropurulent exudate, bed with liquefaction necrosis, edema and perilesional pallor. The management of the lesions during the visits consisted of cleaning with ozonized distilled water; transcutaneous application of ozone (on the first day 90 mcg, oon the others 30 mcg) for 20 minutes.

Results

On the first day of outpatient care, all the patients had severe pain, graded between 9 and 10, and in one of them it wasn’t even possible to carry out proper debridement and measurement of the lesion. All the patients used morphine 10 mg every 6 hours, often in combination with tramal and paracetamol. None of the patients had any comorbidities. In addition to the wound itself and the pain, the patients verbalized insomnia, inappetence, sadness, irritability and fear due to the pain. One week after the application of transcutaneous ozone therapy by bag, all the patients had considerably reduced their pain to 4, 5 and 2 respectively. In case 1, after 28 days (four ozone therapy sessions) complete regeneration was achieved after 35 days (five applications). In case 2, two ozone therapy sessions (21 days) were carried out to completely heal the wound and in case 3, two ozone therapy sessions (28 days) were carried out to completely heal the wound. No patient developed an infection.

Conclusions

Current scientific evidence suggests that the use of ozone therapy as an adjuvant in patient contributes to reducing costs, infections and complications, as well as speeding up the healing process and healing process and improving the quality of life of these victims. However, the literature lacks robust studies that can evaluate the effectiveness of ozone in reducing pain in burn patients.

References

1- De Souza LRP, Lima MFAB, Dias RO, Cardoso EG, Briere AL, Silva JO. The treatment of burns: a review. [Internet]. 2021 Apr 9;7(4). DOI:10.34117/bjdv7n4-257.

2- Girondi J, et al. Ozone therapy in the treatment of wounds in adults: integrative review. Brazilian J Dev [Internet]. 2021;7(7):68912–25. DOI:10.34117/bjdv7n7-191
.
3- Bocci V. OZONE [Internet]. Dordrecht: Springer Netherlands; 2011. Available from:
https://link.springer.com/10.1007/978-90-481-9234-2.

4- Murphy C, Atkin L, Swanson T, Tachi M, Tan YK, Vega de Ceniga M, Weir D, Wolcott R. International consensus document. Defying hard-to-heal wounds with an early antibiolm intervention strategy: wound hygiene. J Wound Care 2020; 29(Suppl 3b):S1-28.

Presenting Author

Juliana Balbinot Reis Girondi

Poster Authors

Juliana Balbinot Reis Girondi

Higher education

Federal University of Santa Catarina

Lead Author

E-mail

Julia Grisard de Bem. Higher education

SOS Cardio Hospital

Lead Author

E-mail

Cilene Fernandes Soares

University Hospital

Lead Author

E-mail

Lúcia Nazareth Amante

Federal University of Santa Catarina

Lead Author

E-mail

Milena Ronize Calegari

Sana Klinikum Offenbach Hospital

Lead Author

E-mail

Felipe Duarte

Military Police Hospital

Lead Author

E-mail

Tamyres Bertola

University Hospital

Lead Author

E-mail

Topics

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