Ozone Therapy for Wound Care

Ozone therapy accelerates wound healing, fights infection (including antibiotic-resistant bacteria), and supports tissue repair. It’s particularly valuable for wounds that are slow to heal or have become infected.

When is ozone used for wounds?

Ozone therapy is beneficial for a wide range of wound types across species:

• Surgical wounds — post-operative healing, dehiscence (wound breakdown)
• Chronic wounds — ulcers, pressure sores, non-healing injuries
• Infected wounds — including antibiotic-resistant infections like MRSA
• Traumatic injuries — lacerations, bite wounds, road traffic injuries
• Burns and skin loss
• Proud flesh (exuberant granulation) in horses

It’s particularly useful for immunocompromised animals, diabetic patients, or elderly animals where healing is naturally slower.

How does it work?

Ozone promotes wound healing through several mechanisms:

• Antimicrobial action — ozone destroys bacteria, fungi, and viruses by oxidising their cell walls. Importantly, pathogens are far less likely to develop resistance to ozone compared to antibiotics.
• Improved oxygenation — enhances oxygen delivery to tissues, supporting cellular repair
• Growth factor stimulation — triggers release of PDGF, VEGF, and other healing factors
• Anti-inflammatory effects — modulates the inflammatory response to reduce swelling and pain
• Biofilm disruption — breaks down protective bacterial biofilms that antibiotics struggle to penetrate

Mechanisms of Action

Ozone exerts effects via:

1. Direct oxidative damage to pathogen membranes
2. Stimulation of Nrf2 pathway and endogenous antioxidants
3. Improved erythrocyte deformability enhancing microcirculation
4. Upregulation of HIF-1α and downstream growth factors
5. Modulation of NF-κB and inflammatory cytokines.

How is it applied?

Several application methods are available depending on wound type and location:

• Ozonated oils — applied directly to wounds, providing sustained antimicrobial action. Suitable for home use under veterinary guidance.
• Ozonated water — used for wound irrigation and cleaning, particularly for fresh or heavily contaminated wounds.
• Ozone bagging — the affected area (usually a limb) is enclosed in a bag filled with ozone gas. Useful for large or awkwardly located wounds.
• Perilesional injection — ozone gas injected around deep or necrotic wounds to enhance local effects.

Treatment Protocol

Typical protocol: 2-3 applications per week for 2-4 weeks, reducing frequency as healing progresses. For ozonated oils, apply thin layer to cleaned wound 1-2x daily. Higher ozonation (PV >800) for infected wounds; moderate (PV 400-600) for maintenance. Integrates well with laser therapy, PRP, and negative pressure wound therapy.

What to expect

Most animals tolerate ozone wound treatment very well. You may notice:

• Reduced wound odour within the first few applications
• Decreased discharge and signs of infection
• Visible improvement in tissue quality within 1-2 weeks
• Gradual wound contraction and epithelialisation

Treatment duration depends on wound severity; minor wounds may heal within days, while chronic wounds may require several weeks of treatment.

Evidence

Multiple studies support ozone therapy for wound healing:

Romary et al. (2023) Liquid ozone therapies for the treatment of epithelial wounds: A systematic review and meta-analysis (International Wound Journal, 20(4), 1235–1252. https://doi.org/10.1111/iwj.13941)

Aydin & Kumandaş (2022) Evaluation of the Effect of Ozone Therapy on the Treatment of Cutaneous Wounds with Tissue-loss in Dogs and Cats (Journal of Advances in VetBio Science and Techniques, 7(3), 313–320. https://doi.org/10.31797/vetbio.1104760)

Silva et al. (2021) Topical Application of Ozonated Oils for the Treatment of MRSA Skin Infection in an Animal Model of Infected Ulcer (Biology, 10(5), 372. https://doi.org/10.3390/biology10050372)

Filippo et al. (2020) Effects of pure and ozonated sunflower seed oil (Helianthus annuus) on hypergranulation tissue formation, infection and healing of equine lower limb wounds (Revista Brasileira de Medicina Veterinária, 42(1), e113520. https://doi.org/10.29374/2527-2179.BJVM1115321)

Anzolin et al. (2020) Ozonated oil in wound healing: what has already been proven? (Medical Gas Research, 10(1), 54–59. https://doi.org/10.4103/2045-9912.279985)

Safety

Ozone wound therapy has an excellent safety profile:

• Ozonated oils are non-toxic and safe if licked in small amounts
• Minimal irritation — often better tolerated than conventional antiseptics
• No contribution to antibiotic resistance
• No systemic side effects from topical application

Seek veterinary advice if wounds show signs of worsening, systemic infection develops, or there’s no improvement after a week of treatment.