THE USE OF OXYGEN-OZONE THERAPY, BY BAGGING, AS ADJUVANT TREATMENT, ON THE HEALING OF AN EXTENSIVE SURGICAL WOUND AFTER A TOTAL KNEE REPLACEMENT: A CASE REPORT: S. Di Cianni1, C. Bernacca2, N. Franco1, C. Spadaccini1, M. Rossi1 | 1Department of Anaesthesiology and Reanimation, Section of Pain Management, Presidio Ospedaliero del Levante Ligure, La Spezia, Italy; 2MD in Training Program in Anaesthesiology at University of Pisa, Section of Pain Management, Presidio Ospedaliero del Levante Ligure, La Spezia, Italy

Introduction. Numerous studies have confirmed that ozone can facilitate wound healing by improving skin micro-circulation. Ozone therapy due to its natural healing capacity if used in small and safe ozone doses, can be efficient for improving the quality of life in cases with chronic wounds. (1) (2)Methods. We present a case of a 66-year-old male with a surgical dehiscence following a robotic total knee replacement surgery, complicated by patella tendon rupture that underwent surgical repair twice. Due to the repeated surgeries and the severe state of inflammation the wound was not healing, and the patient was subjected to wound cleaning and debridement to avoid infections, followed by Vacuum Assisted Closure therapy with poor results on the wound status. A protocol of oxygen-ozone bagging was started, which consisted in placing a bag around the wound filled with ozone mixture of 30 mg/ml dose for 30 minutes, along with daily wound cleaning and sterile dressing. The ozone bagging was applied once a week, for a total of 7 sittings, until complete wound closure was obtained, with no further complications. Figure A (before treatment) and Figure B (end of treatment).Results. At 2 months follow up, the patient was walking with knee brace and crutches, continuing the rehabilitation program and returning to an independent life, with a significant pain reduction, no sensory and motility deficits.Conclusion. This case supports the fact that oxygen-ozone bagging can be an appropriate adjuvant approach in the comprehensive treatment of chronic wounds, especially with regards to extensive orthopaedic wounds.(3) (4)