Topical Ozone as an Adjuvant Therapy in Wound Management: An Integrative Review

Background/Objectives: Wound management remains a clinical challenge, particularly in chronic and refractory conditions. Ozone, due to its antimicrobial, anti-inflammatory, and tissue-regenerative properties, has emerged as promising adjuvant therapy. This integrative re-view aimed to critically analyze the therapeutic effects, routes of administration, benefits, and limitations of ozone in wound treatment. Methods: The review followed the Joanna Briggs In-stitute methodology and the PRISMA 2020 guidelines. Studies were identified through compre-hensive search in the SCOPUS, CINAHL Ultimate, MEDLINE Ultimate, and MedicLatina data-bases, with no time restrictions. Inclusion criteria encompassed primary studies involving adults (≥18 years) with wounds treated with ozone. The methodological quality of the selected studies was assessed using the tools recommended by JBI. Results: Nine reports published between 2019 and 2025 met the inclusion criteria. The findings consistently demonstrated clinical benefits of ozone therapy, including accelerated wound healing, pain reduction, and infection control. The forms of application included ozonated water, ozonated olive oil, and gaseous ozone. However, heterogeneity was observed in ozone concentration, frequency, and treatment duration. The methodological quality of the included studies ranged from moderate to high. Conclusions: The available evidence indicates that ozone may represent promising adjuvant treatment for certain types of wounds; however, the quality and independence of the existing studies are limited, and the lack of standardized protocols as well as methodological variability restrict the generalizability of the findings. Therefore, more robust clinical trials are needed to strengthen the evidence base and support its clinical implementation.