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Abstract(s)
Contexto: A ozonoterapia é uma terapia utilizada numa vasta área de aplicações clínicas devido às suas propriedades imunológicas, antimicrobianas e capacidade de oxigenação. Dadas as suas propriedades, nas últimas décadas tem sido utilizada no tratamento de úlceras de perna de etiologia venosa.
Objetivo: Determinar a eficácia do uso tópico de ozonoterapia (bag de ozono e óleos ozonizados) na redução do tempo de cicatrização, na redução da carga bacteriana e no impacto na qualidade de vida dos utentes portadores de úlceras de etiologia venosa do membro inferior.
Métodos: Foi realizada uma revisão sistemática da literatura sobre estudos que avaliam o efeito da aplicação tópica de ozonoterapia em úlceras de perna de etiologia venosa, publicados entre janeiro de 2000 e novembro de 2016. Foram consultadas as bases de dados eletrónicas PubMed, Ebsco (CINAHL Complete, MedicLatina, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Nursing & Allied Health Collection: Comprehensive), Scielo e literatura expressa nos cadernos de resumos dos Congressos Internacionais de Ozonoterapia.
A qualidade dos estudos recuperados foi avaliada por dois revisores com base na “JBI Critical Appraisal Checklist for Quasi-Experimental Studies” (2016) e através da “Grelha para avaliação crítica de um artigo descrevendo um ensaio clínico prospetivo, aleatorizado e controlado” de Carneiro (2008). A análise estatística foi realizada com recurso ao programa RevMan 5.3.
Resultados: Foram recuperados três estudos com um total de 133 portadores de úlceras venosas, distribuídos em dois grupos, em que os grupos de estudo receberam tratamento convencional combinado com ozonoterapia tópica e os grupos de controlo receberam apenas tratamento convencional. Após meta-análise verificou-se que a ozonoterapia tópica tem influência estatisticamente significativa na cicatrização das úlceras venosas comparativamente aos resultados obtidos pela terapia convencional apenas, exibindo p <0.00001, com IC 95%, OR= 7.28 [3.56-14.89] e heterogeneidade moderada entre os estudos conforme se apura pelo resultado do X2=3.83 (p= 0.15) e pelo I2= 48%.
Verificaram-se resultados relevantes na diminuição do tempo de cicatrização e maior redução dos sinais de infeção nos grupos que receberam ozonoterapia tópica em oposição aos resultados dos grupos que receberam apenas terapia convencional, contudo não foi possível realizar meta-análise destes outcomes por não haver dados suficientes nos estudos. A qualidade de vida não foi avaliada em nenhum dos estudos.
Conclusões: A ozonoterapia tópica revela-se pertinente para o tratamento adjuvante das úlceras de perna de etiologia venosa, sobretudo pelos seus efeitos benéficos na cicatrização e controlo da infeção que poderão conduzir à redução dos custos associados ao tratamento e à possível diminuição da morbilidade associada às úlceras de perna, com consequente melhoria na qualidade de vida dos utentes.
Palavras-chave: ozonoterapia, úlcera venosa, cicatrização de feridas.
Abstract Background: The ozone therapy is a therapy used in a wide area of clinical applications due to its immunological, antimicrobial and oxygenation capacity. Given its properties, in the last decades, it has been used to treat venous leg ulcers. Aim: To determine the efficacy of the topical use of ozone therapy (ozone bag and ozonized oils) in reducing healing time, reducing the bacterial load and the impact on quality of life of venous leg ulcer’s patients. Methods: A systematic literature review of studies evaluating the effect of topical application of ozone therapy in venous leg ulcers has been held for studies published between January 2000 and November 2016. There has been consulted the electronic databases PubMed, Ebsco (CINAHL Complete, MedicLatina, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Nursing & Allied Health Collection: Comprehensive), Scielo and literature expressed in the abstracts of the International Ozone Therapy Congresses. The quality of the studies found has been evaluated by two reviewers based on the “JBI Critical Appraisal Checklist for Quasi-Experimental Studies” (2016) and with the “Critical evaluation scale of a study describing a prospective, randomized and controlled trial by Carneiro (2008). Statistical analysis was performed using the RevMan 5.3 program. Results: Three studies were retrieved with a total of 133 venous leg ulcer patients, divided into two groups, in which the study groups received conventional treatment combined with topical ozone therapy and the control groups received only conventional treatment. A meta-analysis was performed and it was verified that topical ozone therapy has a statistically significant influence on the healing of venous ulcers compared to the results obtained by conventional therapy alone, showing p <0.00001, with CI 95%, OR= 7.28 [3.56-14.89] and moderate heterogeneity among the studies as shown by X2=3.83 (p= 0.15) and I2= 48%. Relevant results were observed in decreasing healing time and further reduction of signs of infection in the groups that received topical ozone therapy as opposed to the results of the groups receiving conventional therapy alone, however it was not possible to perform a meta-analysis of these outcomes because there are not enough data in the studies. None of the studies has evaluated the quality of life. Conclusions: Topical ozone therapy is relevant for the adjuvant treatment of venous leg ulcers, mainly because of its beneficial effects on wound healing and infection control, which may lead to reduction of costs associated with treatment and possible reduction of morbidity associated with venous leg ulcers, with consequent improvement in the quality of life of the patients. Keywords: ozone therapy, venous leg ulcer, wound healing.
Abstract Background: The ozone therapy is a therapy used in a wide area of clinical applications due to its immunological, antimicrobial and oxygenation capacity. Given its properties, in the last decades, it has been used to treat venous leg ulcers. Aim: To determine the efficacy of the topical use of ozone therapy (ozone bag and ozonized oils) in reducing healing time, reducing the bacterial load and the impact on quality of life of venous leg ulcer’s patients. Methods: A systematic literature review of studies evaluating the effect of topical application of ozone therapy in venous leg ulcers has been held for studies published between January 2000 and November 2016. There has been consulted the electronic databases PubMed, Ebsco (CINAHL Complete, MedicLatina, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Nursing & Allied Health Collection: Comprehensive), Scielo and literature expressed in the abstracts of the International Ozone Therapy Congresses. The quality of the studies found has been evaluated by two reviewers based on the “JBI Critical Appraisal Checklist for Quasi-Experimental Studies” (2016) and with the “Critical evaluation scale of a study describing a prospective, randomized and controlled trial by Carneiro (2008). Statistical analysis was performed using the RevMan 5.3 program. Results: Three studies were retrieved with a total of 133 venous leg ulcer patients, divided into two groups, in which the study groups received conventional treatment combined with topical ozone therapy and the control groups received only conventional treatment. A meta-analysis was performed and it was verified that topical ozone therapy has a statistically significant influence on the healing of venous ulcers compared to the results obtained by conventional therapy alone, showing p <0.00001, with CI 95%, OR= 7.28 [3.56-14.89] and moderate heterogeneity among the studies as shown by X2=3.83 (p= 0.15) and I2= 48%. Relevant results were observed in decreasing healing time and further reduction of signs of infection in the groups that received topical ozone therapy as opposed to the results of the groups receiving conventional therapy alone, however it was not possible to perform a meta-analysis of these outcomes because there are not enough data in the studies. None of the studies has evaluated the quality of life. Conclusions: Topical ozone therapy is relevant for the adjuvant treatment of venous leg ulcers, mainly because of its beneficial effects on wound healing and infection control, which may lead to reduction of costs associated with treatment and possible reduction of morbidity associated with venous leg ulcers, with consequent improvement in the quality of life of the patients. Keywords: ozone therapy, venous leg ulcer, wound healing.
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Keywords
Administração tópica Cicatrização de feridas Ozono, farmacologia Ozono, uso terapêutico Revisão Úlcera varicosa Administration, topic Ozone, pharmacology Ozone, therapeutic use Review Varicose ulcer Wound healing