Combined Ozone Therapy and Negative Pressure Wound Therapy with Instillation for Charcot Neuroarthropathy-Associated Foot Wounds
- 1Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, University Clinical Centre, Smoluchowskiego St. 17, 80-214 Gdansk, Poland
- 2ETER-MED, Wound Care Clinic, Non-Public Healthcare Centre, 80-822 Gdansk, Poland
- 3Department 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
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.
Related
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BibTeX
@article{kuzmiukglembin2026combined,
title = {{Combined Ozone Therapy and Negative Pressure Wound Therapy with Instillation for Charcot Neuroarthropathy-Associated Foot Wounds}},
author = {Izabella Kuźmiuk-Glembin and Agnieszka Białomyzy and Daniel Kotrych and Michał Sadowski and Bogdan Biedunkiewicz and Leszek Tylicki and Tomasz Niewęgłowski},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218479},
url = {https://www.mdpi.com/2077-0383/15/21/8479},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Combined Ozone Therapy and Negative Pressure Wound Therapy with Instillation for Charcot Neuroarthropathy-Associated Foot Wounds
AU - Izabella Kuźmiuk-Glembin
AU - Agnieszka Białomyzy
AU - Daniel Kotrych
AU - Michał Sadowski
AU - Bogdan Biedunkiewicz
AU - Leszek Tylicki
AU - Tomasz Niewęgłowski
PY - 2026
DA - 2026/10/30
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218479
UR - https://www.mdpi.com/2077-0383/15/21/8479
AB - 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.
SN - 2077-0383
ER -