The role of ozonated Aloe vera oil in full-thickness skin defects: Macrophage count and epithelization length parameter

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Background: Aloe vera has been reported to enhance keratinocyte proliferation and migration, and thereby accelerate wound healing. Ozone therapy is an alternative medicine with disinfecting properties and strong oxidative stress induction capacity. This study aimed to evaluate the effect of Aloe vera oil provided with different dosages of ozone in accelerating the healing rate comparing two-phases; inflammation (day 3) and proliferation (day 7) of full-thickness defect wounds in Sprague Dawley rats as an adjuvant treatment based on macrophage count and new epithelialization length. Methods: We conducted a study using a post-test only control group design, where a total of 50 Sprague Dawley rats were randomized into ten groups. Two control groups were administered Aloe vera oil (P1, P6), while gentamicin ointment was used in the other control group (P2, P7). Ozonated Aloe vera oil dose was used: 600 mg/ml (P3,P8), 1200 mg/ml (P4,P9), and 1800 mg/ml (P5,P10). Groups P1, P2, P3, P4, P5 were terminated on the 3rd day, while P6, P7, P8, P9, P10 were evaluated on the 7th day. Macrophage counts were assessed using a 100x magnification microscope, through hematoxylin-eosin (HE) staining, and paraffin block with Masson trichrome staining was used to measure the new epithelialization length. Results: There were significant differences in the macrophage count on day three between the group-administered gentamicin (P2) and 1800 mg/ml ozonated Aloe vera oil (P5) (79.96;131.96, p<0,05). The new epithelialization length significantly increased in the group provided with wound treatment up to day 7, using 1800 mg/ml ozonated Aloe vera oil (P10), compared to non-ozonated Aloe vera (P6) and the gentamicin therapy (P7) (1160.88 µm; 1367.64; 2451.40 μm, p<0,05). Conclusions: The application of ozonated Aloe vera oil to full-thickness skin defects in Sprague Dawley rats resulted in a higher macrophage count and longer new epithelialization length than in controls.