Ozonated water as an adjunct in the management of combat-induced wounds: a prospective study

Abstract

The aim of the work: to evaluate the effectiveness of electrolytically generated ozonated water as an adjunctive therapy in the treatment of complicated, infected combat-induced wounds. Materials and Methods. This prospective study included 27 patients with combat-related injuries treated at the Swedish-Ukrainian Medical Center “Angelholm” (Chernivtsi, Ukraine). Wound management included debridement, necrectomy, stabilization of fractures, partial wound closure, and application of negative pressure wound therapy (NPWT) in deep or complex wounds. Electrolytically ozonated water (up to 4 mg/L) was used for wound irrigation during each dressing and NPWT system change. Microbiological cultures were collected routinely, and bacterial identification and antibiotic susceptibility were performed using the Vitek-2 Compact system. Results. A total of 45 microbial isolates were identified from 27 patients, with Acinetobacter baumannii (28.89 %) and Staphylococcus aureus (20.00 %) being the most common pathogens. Some patients had mixed infections, and most of the isolates were multidrugresistant. The use of ozonated water resulted in improved wound conditions, including fresh granulation tissue formation and absence of graft rejection following skin grafting. Patients experienced reduced edema, intoxication symptoms, and pain, contributing to improved quality of life during the healing period. Conclusions. Electrolytically generated ozonated water proved to be a safe and effective adjunctive therapy in the management of complex combat-related injuries. Its antimicrobial activity, clinical safety, and ease of application make it a valuable addition to wound care protocols, especially in settings with high rates of multidrug-resistant infections.