Direct Endolymphatic Ozone Therapy in Patients with Diabetic Foot Syndrome: Analysis of the Effectiveness

Introduction. Chronic inflammatory process on the foot leads to the depletion of immune defense mechanisms against infection in patients with diabetes mellitus. Application of ozonized solutions, endolymphatic therapy contributes to fight against the infectious process and maintenance of the body homeostasis.
The aim of the study was to evaluate safety and clinical effectiveness of direct endolymphatic ozone therapy in patients with purulent-necrotic complications of diabetic foot syndrome.
Methods. Clinical outcomes of direct endolymphatic ozone therapy, being part of complex therapy, were analyzed in 23 patients with purulent-necrotic complications of diabetic foot syndrome. Inclusion criteria were the degree of damage to the foot according to Wagner 2-4, ankle-brachial index (ABI) less than 0.7. Direct antegrade endolymphatic ozone therapy consisted of introduction of ozonized isotonic sterile sodium chloride solution into the lymphatic collector of the middle third leg for 5 days. The parameters of treatment duration, degree of the pain syndrome, severity of surgical intervention, dynamics of the bacterial contamination, leukocytes and blood lymphocytes, leukocyte indices were assessed.
Results. Under endolymphatic ozone therapy, all patients reported positive changes in subjective perception, the level of peripheral blood lymphocytes increased by 15.3%, which reflected an improvement in the adaptive potential of the body, bacterial contamination decreased by 68.6%, the severity of operations decreased by 39.4%. The duration of treatment did not change statistically significant.
Conclusion. Direct endolymphatic ozone therapy is an effective way to influence the course of the purulent-necrotic process in the complex treatment of diabetic syndrome. The main focus of the technique is correction of the bacterial contamination of inflammation; this option promotes activation of reparative processes in the wound, reduces the risk of infection generalization, and preserves a limb footing ability. The use of leukocyte indices to assess the course of the inflammatory process on the foot in patients with diabetes mellitus is difficult in clinical practice due to the decreased body's reactivity.