Hard-to-heal wounds pose significant therapeutic challenges due to pathogenic microorganisms and associated infections, leading to delays in tissue healing. The present study aimed to carry out a clinical trial to identify the microbial agent present in hard-to-heal wounds on the lower limbs, assess the antimicrobial effects of ozonated oil and examine the benefits of photobiomodulation combined with ozonated oil in the treatment of those wounds. Then we examined the antimicrobial kinetics of ozonated oil on microorganisms found in wounds by an in vitro study. For this study, some commercial ozonated sunflower oil was used as well as the LED photobiomodulation therapy, 660 nm, 30 seconds, punctual 2 cm away on the wound bed, 120 mW, 3.6 J per point. The procedure was performed three times a week. The clinical results evidenced a significant healing of injuries treated with ozonated oil and photobiomodulation, evidenced by a reduction in traces of infection, presence of granulation tissue, wound area reduction and, in some cases, full wound closure. Among the eight patients monitored, only one had negative microbiology. Among the microorganisms identified are Klebsiella sp, Staphylococcus epidermidis and Escherichia coli, all proved resistant to the antibiotics tested. In vitro results confirmed the antimicrobial efficacy of ozonated oil, demonstrating its potential as a viable therapeutic agent for chronic wounds in all microorganisms tested when subjected to concentrations deemed low, ranging from 1.6% to 12.5%, demonstrating antibacterial activity. In conclusion, ozonated oil associated with photobiomodulation therapy represents a promising resource for the treatment of hard-to-heal wounds. However, new clinical trials are necessary to establish more improved treatment protocols.
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