Efficacy of Ozone Bagging Therapy in Equine Chronic Distal Limb Wounds: Clinical Evaluation of Eight Cases.
Abstract: Limb wounds in horses represent a significant therapeutic challenge due to poor vascularization, reduced skin elasticity, and high risk of complications such as exuberant granulation tissue. Conventional treatments sometimes fail to provide satisfactory healing outcomes, leading to prolonged recovery and increased costs. This study aimed to evaluate the efficacy of topical ozone therapy using the bagging method in promoting the epithelialization and contraction of chronic distal limb wounds in horses refractory to conventional management. Eight horses, aged 3-21 years, with chronic wounds averaging 48.79 ± 21.20 cm, were treated exclusively with ozone (50 μg/mL) administered by bagging for 30 min every 48 h until complete healing. All cases achieved full wound closure within 27-91 days without systemic medication or major complications. Macroscopic evaluation showed favorable healing, with the restoration of skin pigmentation and hair growth in most cases, while only minimal fibrous scarring was observed in a few patients. Statistical analysis revealed significant improvements in epithelialization, particularly during the last four weeks of treatment. These findings suggest that ozone bagging therapy is a simple, cost-effective, and well-tolerated method that may enhance the healing of chronic distal limb wounds in horses. Further controlled trials are needed to standardize treatment protocols and compare ozone with conventional therapies.
Publication Date: 2025-12-23 PubMed ID: 41600672PubMed Central: PMC12846506DOI: 10.3390/vetsci13010016Google Scholar: Lookup
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APA
Repciuc CC, Oros NV, Mureșan ȘMC, Sevastre B, Joaquim JGF, Oana LI.
(2025).
Efficacy of Ozone Bagging Therapy in Equine Chronic Distal Limb Wounds: Clinical Evaluation of Eight Cases.
Vet Sci, 13(1), 16.
https://doi.org/10.3390/vetsci13010016 Publication
Researcher Affiliations
- Department of Surgery, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania.
- Department of Internal Medicine, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania.
- Department of Surgery, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania.
- Department of Pathophysiology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania.
- Bioethicus Institute, Botucatu 18605-545, SP, Brazil.
- Department of Surgery, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania.
Conflict of Interest Statement
The authors declare no conflicts of interest.
References
This article includes 40 references
- Harman RM, Theoret CL, Van de Walle GR. The horse as a model for the study of cutaneous wound healing.. Adv. Wound Care 2021;10:381–399.
- Jacobs KA, Leach DH, Fretz PB, Townsend HGG. Comparative aspects of the healing of excisional wounds on the leg and body of horses.. Vet. Surg. 1984;13:83–90.
- Bertone A. Management of exuberant granulation tissue.. Vet. Clin. N. Am. Equine Pract. 1989;5:551–556.
- Jørgensen E, Bay L, Skovgaard LT, Bjarnsholt T, Jacobsen S. An equine wound model to study effects of bacterial aggregates on wound healing.. Adv. Wound Care 2019;8:487–498.
- García CA, Eurides D, Berbert RP, Rodrigues M, Neves SMN, Rinaldi F. Skin healing in one equine by therapy with ozone.. Rev. CENIC Cienc. Biol. 2010;41:1–6.
- Travagli V, Zanardi I, Bocci V. Topical applications of ozone and ozonated oils as anti-infective agents: An insight into the patent claims.. Recent Pat. Anti-Infect. Drug Discov. 2009;4:130–142.
- Travagli V, Zanardi I, Valacchi G, Bocci V. Ozone and ozonated oils in skin diseases: A review.. Mediat. Inflamm. 2010;2010:610418.
- Miura T, Iwai A, Tamoto K, Yamazaki A, Nochi H. Components and anti-inflammatory action mechanism of ozonized olive oil. Proceedings of the 19th Ozone World Congress of the IOA; Tokyo, Japan. 31 August–3 September 2009; pp. 145–166.
- Valacchi G, Lim Y, Belmonte G, Miracco C, Zanardi I, Bocci V, Travagli V. Ozonated sesame oil enhances cutaneous wound healing in SKH1 mice.. Wound Repair Regen. 2011;19:107–115.
- ISCO3. Madrid Declaration on Ozone Therapy.. 3rd ed. International Scientific Committee of Ozone Therapy; Madrid, Spain: 2020.
- Camps-Ramírez AM, Claro-González JN, Cuesta-Guillén A. Aplicación tópica del oleozón como alternativa de tratamiento en lesiones causadas por fricción en caballos de tiro.. REDVET Rev. Electrón. Vet. 2006;7:1695–7504.
- Kosachenco B, Calliari C, Appel B, Mentz F, Malschitzky E. Efecto terapéutico de la Ozonoterapia en la cicatrización de heridas en perros: Reporte de casos.. Rev. Esp. Ozonoter. 2018;8:197–210.
- Kim HS, Noh SU, Han YW, Kim KM, Kang H, Kim HO, Park YM. Therapeutic effects of topical application of ozone on acute cutaneous wound healing.. J. Korean Med. Sci. 2009;24:368–374.
- Hendrickson D, Virgin J. Factors that affect equine wound repair.. Vet. Clin. N. Am. Equine Pract. 2005;21:33–44.
- WFOT. WFOT’s Review on Evidence-Based Ozone Therapy.. World Federation of Ozone Therapy, 2015. [(accessed on 6 September 2023)]. Available online: https://www.wfoot.org/.
- Zhang J., Guan M., Xie C., Luo X., Zhang Q., Xue Y. Increased growth factors play a role in wound healing promoted by noninvasive oxygen-ozone therapy in diabetic foot ulcers. Oxidative Med. Cell. Longev. 2014;2014:273475. doi: 10.1155/2014/273475.
- Bocci V. Ozone. Springer; Dordrecht, The Netherlands: 2010. pp. 17–24.
- Repciuc C.C., Luca V., Chirilă F., Pop G., Oana L.I. Antibacterial effect of topical ozone in horses with distal limb infected wounds. Agricultura. 2019;111:328–332.
- Montevecchi M., Dorigo A., Cricca M., Checchi L. Comparison of the antibacterial activity of an ozonated oil with chlorhexidine digluconate and povidone-iodine: A disk diffusion test. New Microbiol. 2013;36:289–302.
- Carrijo B.N., Pires R.H., Costa G.B., Guiotto F.G., Rodrigues V.S., Ferreira J.C. Ozone gas and ozonized sunflower oil as alternative therapies against Pythium insidiosum isolated from dogs. Ozone Sci. Eng. 2022;44:398–406. doi: 10.1080/01919512.2021.1937511.
- Ferreira J.C., Pires R.H., Costa G.B.D., Carrijo B.N., Guiotto F.G., Rodrigues V.S. The in vitro effect of ozone therapy against equine Pythium insidiosum. J. Equine Vet. Sci. 2021;98:103305. doi: 10.1016/j.jevs.2020.103305.
- Paz G.S., Camargo G.G., Cury J.E., Apolonio E.V.P., Garces H.G., Prado A.C.D., Chechi J.L., Oliveira A.L., Watanabe M.J., Bagagli E., et al. Outbreak of equine pythiosis in a southeastern region of Brazil: Environmental isolation and phylogeny. Transbound. Emerg. Dis. 2021;69:1617–1624. doi: 10.1111/tbed.14135.
- Di Filippo P.A., Ribeiro L.M.F., Gobbi F.P., Lemos G.B., Rodrigues R.B.R., Jerdy H., da Silva L.C., Viana I.S., Quirino C.R. Effects of pure and ozonated sunflower seed oil on hypergranulation, infection, and healing of equine distal limb wounds. Braz. J. Vet. Med. 2020;42:e113520. doi: 10.29374/2527-2179.bjvm1115321.
- María A., Calles E., Denis R., Labrada A. El oleozón como nueva alternativa terapéutica en medicina veterinaria. REDVET Rev. Electrón. Vet. 2006;7:1–5.
- Romary D.J., Landsberger S.A., Bradner K.N., Ramirez M., Leon B.R. Liquid ozone therapies for epithelial wounds: A systematic review and meta-analysis. Int. Wound J. 2023;20:1235–1252. doi: 10.1111/iwj.13941.
- Araujo A.L., Teixeira F.A., Lacerda T.F., Flecher M.C., Souza V.R.C., Coelho C.S. Effects of topical application of pure and ozonized andiroba oil on experimentally induced wounds in horses. Braz. J. Vet. Res. Anim. Sci. 2017;54:66. doi: 10.11606/issn.1678-4456.bjvras.2017.113776.
- Flamia L.B.G., Wilmsen M.O. Utilização de três técnicas de ozonioterapia no tratamento de ferida em casco equino: Relato de caso. Braz. J. Dev. 2021;7:104613–104623. doi: 10.34117/bjdv7n11-198.
- Bocci V. Oxygen-Ozone Therapy. Springer; Dordrecht, The Netherlands: 2002.
- Carnevali F., Argentieri M., Ippedico G., Minniti C.A., Amodio L., Mellano L., van der Esch S.A. Managing horse wounds with or without exuberant granulation tissue using an innovative wound dressing: A retrospective study. Anim. Vet. Sci. 2014;1:6–16.
- Pchepiorka R., Moreira M.S., Lascane N.A.S., Catalani L.H., Allegrini S., Jr., de Lima N.B., Gonçalves E.F. Effect of ozone therapy on wound healing in rat buccal mucosa. Arch. Oral Biol. 2020;119:104889. doi: 10.1016/j.archoralbio.2020.104889.
- Huth K.C., Saugel B., Jakob F.M., Cappello C., Quirling M., Paschos E., Ern K., Hickel R., Brand K. Effect of aqueous ozone on the NF-κB system. J. Dent. Res. 2007;86:451–456. doi: 10.1177/154405910708600512.
- Luo J., Chen A.F. Nitric oxide: A newly discovered role in wound healing. Acta Pharmacol. Sin. 2005;26:259–264. doi: 10.1111/j.1745-7254.2005.00058.x.
- Re L., Sanchez G.M., Mawsouf N. Clinical evidence of ozone interaction with pain mediators. Saudi Med. J. 2010;31:1363–1367.
- Rilling S., Viebahn R. The Use of Ozone in Medicine. Haug Publishers; Heidelberg, Germany: 1987.
- Cisterna B., Costanzo M., Lacavalla M.A., Galiè M., Angelini O., Tabaracci G., Malatesta M. Low ozone concentrations affect structural and functional features of fibroblasts in vitro. Int. J. Mol. Sci. 2021;22:10133. doi: 10.3390/ijms221810133.
- Ogut E. Mechanisms and therapeutic potential of ozone therapy in enhancing vasculogenesis and angiogenesis through growth factor activation and oxidative signaling pathways. Discov. Med. 2025;2:240. doi: 10.1007/s44337-025-00491-7.
- He S., Chen W., Xia J., Lai Z., Yu D., Yao J., Cai S. Effects of ozone autohemotherapy on blood VEGF, TGF-β and PDGF levels after finger replantation. Ann. Palliat. Med. 2020;9:3332–3339. doi: 10.21037/apm-20-1467.
- Fitzpatrick E., Holland O.J., Vanderlelie J.J. Ozone therapy for the treatment of chronic wounds: A systematic review. Int. Wound. J. 2018;15:633–644. doi: 10.1111/iwj.12907.
- Valacchi G., Fortino V., Bocci V. The dual action of ozone on the skin. Br. J. Dermatol. 2005;153:1096–1100. doi: 10.1111/j.1365-2133.2005.06939.x.
- Silva D.R., Guimarães A.L., Vieira A.M.R.A., Duarte E.D., Almeida E.M., Maximiano H.A., Viana T.D.S., Silva W.S.L. Ozone therapy in equines. Int. J. Adv. Eng. Res. Sci. 2024;11:15–19. doi: 10.22161/ijaers.1112.3.
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