{
  "abstract": "Background/Objectives: Charcot neuro-osteoarthropathy (CNO) complicated by ulceration and infection represents a major limb-preservation challenge in diabetes-related foot disease. Evidence regarding the combined use of ozone therapy (OT) and negative pressure wound therapy with instillation and dwell time (NPWTi-d) remains limited. This study evaluated outcomes of a multimodal treatment protocol incorporating both modalities. Methods: This retrospective study included 30 patients with diabetes and CNO-associated foot wounds managed using a multidisciplinary protocol incorporating OT and NPWTi-d. The primary outcome was wound volume reduction, while secondary outcomes included pain, inflammatory biomarkers, microbiological findings, and safety. Results: Wound volume decreased significantly during follow-up, from a median of 8.0 cm3 at baseline to 1.5 cm3 after 3 weeks, with further reduction to 0 cm3 by week 6 (all p < 0.001). Significant improvements were observed in wound bed characteristics and exudate. Mean pain intensity (NRS) decreased from 6.9 ± 1.1 to 0.9 ± 1.1 points (p < 0.001). CRP and PCT concentrations declined significantly (both p < 0.001). Follow-up wound cultures demonstrated a lower frequency of isolation of several initially identified pathogens. No serious treatment-related adverse events occurred. Conclusions: This retrospective case series demonstrated favourable short-term changes in wound-related outcomes during a multimodal treatment strategy incorporating OT and NPWTi-d in patients with CNO-associated wounds. Given the uncontrolled study design and concurrent interventions, these findings should be considered exploratory and do not establish the independent efficacy of either modality or their combination.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, University Clinical Centre, Smoluchowskiego St. 17, 80-214 Gdansk, Poland",
    "ETER-MED, Wound Care Clinic, Non-Public Healthcare Centre, 80-822 Gdansk, Poland",
    "Department of Orthopaedic Oncology and Reconstructive Surgery, Hereditary Cancer Diagnosis and Treatment Center, Pomeranian Medical University of Szczecin, Unii Lubelskiej St 1, 71-252 Szczecin, Poland"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Izabella Kuźmiuk-Glembin",
      "orcid": "0000-0002-0625-148X"
    },
    {
      "affs": [
        1
      ],
      "name": "Agnieszka Białomyzy"
    },
    {
      "affs": [
        2
      ],
      "name": "Daniel Kotrych"
    },
    {
      "affs": [
        1
      ],
      "name": "Michał Sadowski"
    },
    {
      "affs": [
        0
      ],
      "name": "Bogdan Biedunkiewicz",
      "orcid": "0000-0002-3439-4349"
    },
    {
      "affs": [
        0
      ],
      "name": "Leszek Tylicki",
      "orcid": "0000-0002-5515-5072"
    },
    {
      "affs": [
        1
      ],
      "name": "Tomasz Niewęgłowski"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cm20nr93jt950.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218479",
  "fulltext_url": null,
  "id": "cm20nr93jt950",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8479",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/cm20nr93jt950.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:21:07Z",
      "native_id": "10.3390/jcm15218479",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8479"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Combined Ozone Therapy and Negative Pressure Wound Therapy with Instillation for Charcot Neuroarthropathy-Associated Foot Wounds",
  "title_text": "Combined Ozone Therapy and Negative Pressure Wound Therapy with Instillation for Charcot Neuroarthropathy-Associated Foot Wounds",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T00:21:04Z",
  "url": "https://research.draconitic.com/paper/cm20nr93jt950",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}