Treatment of Diabetic Lower Limb Wounds with Ozonized Sunflower Oil and Collagenase
DOI:
https://doi.org/10.12970/2310-9971.2020.08.03Keywords:
Diabetic foot, Ulcer, Natural compound, Conventional compound, Ozone therapy, Antioxidant action, Healing.Abstract
Scientific studies have proven that ozone presents benefits as a therapeutic agent when used according to well-defined protocols and safe in the health field, it can be a potent oxidant known. The objective of this research was to verify the effectiveness of the treatment with ozonized sunflower oil in cutaneous wounds of diabetic lower limbs, how to isolate and identify the microorganisms present in the wound before and during the treatments, and quantitative evaluating by measuring the diameters of the same. The present research was approved by the Unicastelo Ethics in Research Committee under the number of the opinion 168.652/2012. 6 patients were selected from the municipality of Fernandópolis - SP, and 9 patients in the city of Jales - SP, randomly divided into 2 groups. The curatives were performed by a single trained and calibrated examiner in the homes of each patient being. The research included two groups: group 1 = treatment ozonized sunflower oil (n = 8) and group 2 = treatment with collagenase (n = 7). Weekly samples were collected with sterile swab for culture, isolation and identification of microorganisms present in the wounds. It was found that the ozonized sunflower oil was effective in healing of wounds in the lower limbs of diabetic patients, while collagenase induced healing of certain injuries and other injured areas were increased. It can be concluded that the ozonized sunflower oil caused change in microbiological pattern, which was not seen in patients treated with collagenase.References
[1] Ochoa-Vigo K, Pace AE. Pé diabético: estratégias para prevenção. Acta Paulista de Enfermagem 2005; 18: 100-09. https://doi.org/10.1590/S0103-21002005000100014
[2] Santos ICRV, Barros-Silva ACF, Silva AP, Melo LCP. Condutas preventivas na atenção básica e amputação de membros inferiores em portadores de pé diabético. Rev Rene 2008; 9: 40-8.
[3] International Diabetes Federation. IDF DIABETES ATLAS 9th - Edition 2019 Update. Available from: https://www.diabetesatlas.org/en/
[4] Gross JL, Nehme M. Detecção e tratamento das complicações crônicas do diabetes melito: Consenso da Sociedade Brasileira de Diabetes e Conselho Brasileiro de Oftalmologia. Rev Assoc Med Bras 1999; 45: 279-84. http://dx.doi.org/10.1590/S0104-42301999000300014
[5] Martins DA, Souza AM. O perfil dos clientes portadores de úlcera varicosa cadastrados em programas de saúde pública. Cogitare Enfermagem 2007; 12: 353-57. http://dx.doi.org/10.5380/ce.v12i3.10032
[6] Borges EL, Caliri MHL, Haas VJ. Revisão sistemática do tratamento tópico da úlcera venosa. Rev Latino-am Enfermagem 2007; 15: 1163-70. https://doi.org/10.1590/S0104-11692007000600017
[7] Manhezii AC, Bachion MM, Pereira ÂL. Utilização de ácidos graxos essenciais no tratamento de feridas. Rev Bras Enferm 2008; 61: 620-29. https://doi.org/10.1590/S0034-71672008000500015
[8] Wendt SBT. Comparação da eficácia da calêndula e do óleo de girassol na cicatrização por segunda intenção de feridas em pequenos animais. [Dissertation on the internet]. Universidade Federal do Paraná, Curitiba. 2005. Available from: http://educapes.capes.gov.br/handle/1884/10498
[9] Fiorini CM, Fiorini JE, Macedo SB, Ferreira LR, Cardoso CC. Síndrome de Fournier. Relato de um caso tratado com ozonoterapia tópica. Rev Bras Clin Terap 2002; 28: 185-87.
[10] Martínez-Sánchez G, Al-Dalain SM, Menéndez S, et al. Therapeutic efficacy of ozone in patients with diabetic foot. Eur J Pharmacol 2005; 523: 151-61. https://doi.org/10.1016/j.ejphar.2005.08.020
[11] Kang SN, Kim KI, Lee OH, Park JH. Sensitivities of Salmonella typhimurium and Staphylococcus aureus to ozonation in the presence of soluble starch and metal ion complex. Food Science Biotechnology 2008; 17: 842-45.
[12] Kozusny-Andreani DI, Andreani G, Prado LFA, et al. In vitro inactivation of pathogenic bacteria by the use of ozone in different exposure times. Rev Cubana Med Trop 2018; 70: 34-44.
[13] Silva MH, Jesus MCP, Merighi MAB, Oliveira DM, Santos SMR, Vicente EJD. Manejo clínico de úlceras venosas na atenção primária à saúde. Acta Paul Enferm 2012; 25: 329- 33.
[14] Trabulsi LR, Alterthum F. Microbiologia. São Paulo: Atheneu, 2008.
[15] Motta VT. Bioquímica Clínica para o Laboratório: princípios e interpretações. 4ª ed. São Paulo: Robe, 2003.
[16] Bearzatto A, Vaiano F, Franzini M. O2-O3-therapy of nonhealing foot and leg ulcers in diabetic patients. Eur J Clinical Investigation 2003; 33: 44-46.
[17] Sharma M, Hudson JB. Ozone gas is an effective practical antibacterial agent. Am J Infect Control 2008; 36: 559-63. https://doi.org/10.1016/j.ajic.2007.10.021
[18] Rodrigues KL, Cardoso CC, Caputo LR, Carvalho JCT, Fiorini JE, Schneedorf, JM. Cicatrizing and antimicrobial properties of an ozonized oil from sunflower seeds. Inflammopharmacology 2004; 12: 261-70. https://doi.org/10.1163/1568560042342275
[19] Matsumoto A, Sakurai S, Shinriki N, Suzuki S, Miura T. Therapeutic effects of ozonized olive oil in the treatment of intractable fistula and wound after surgical operation. J Japan Surg Association 2000; 61: 1383-89. https://doi.org/10.3919/jjsa.61.1383
[20] Wainstein J, Feldbrin Z, Boaz M, Harman-Boehm I. Efficacy of ozone-oxygen therapy for the treatment of diabetic foot ulcers. Diabetes Technol Ther 2011; 13: 1255-60. https://doi.org/10.1089/dia.2011.0018
