Ozone Used as a Galenic Adjuvant for Optimizing the Wound-Healing Microenvironment in Diabetic Foot Ulcers: A Preliminary Study in Burkina Faso

Abstract

Introduction: Diabetic foot ulcers are a major source of morbidity and preventable amputations in sub-Saharan Africa, where therapeutic options remain limited. Oxygen-ozone therapy, with its effects on microcirculation, inflammation, and tissue repair, offers a promising adjuvant approach. This study aims to evaluate its clinical efficacy and tolerance in patients managed at the Centre Médical des Sœurs Filles de Saint Camille (CMFISAC). Methods: A prospective observational study was conducted at CMFISAC (August-November 2024) enrolling twelve adults with type 2 diabetes and Wagner grade-1 DFU. Baseline evaluation included a full clinical examination, Doppler assessment, planimetry, and laboratory tests. Patients received twice-weekly ozone bagging (30 µg/mL, 20 min) plus L-Mesitran ® . Healing was monitored through ulcer area reduction, granulation, pain, and infection control, using standardized photography and ImageJ-based quantitative analysis. Results and Discussion : Ozone therapy produced consistent improvement: ulcer area decreased by 71% by day 35, with early granulation (days 12 - 15), progressive epithelialization, reduced inflammation, and 60% - 80% pain reduction. Photographs confirmed rapid tissue restoration. No adverse effects occurred. These outcomes align with ozone’s known antioxidant and anti-inflammatory mechanisms and mirror findings from international trials, supporting its promise as a safe, low-cost adjuvant for early-stage diabetic foot ulcers. Conclusion: Medical ozone therapy appears to be a safe, low-cost, and effective adjuvant for enhancing granulation and epithelialization in diabetic foot ulcers. Larger multicenter randomized trials remain necessary to confirm its benefits and establish standardized dosing protocols.