HISTOLOGICAL EVALUATION OF SKIN WOUNDS IN RATS SUBJECTED TO PHOTOBIOMODULATION AND OZONE THERAPY

Authors

DOI:

https://doi.org/10.47820/recima21.v7i3.7325

Keywords:

Wound healing. Low-Level Light therapy. Ozone therapy. Collagen. Inflammation.

Abstract

Biomodulatory therapies are becoming increasingly common in healthcare to enhance tissue repair. This study aimed to evaluate and compare the effects of laser photobiomodulation, gaseous ozone, and ozonated oil on tissue repair through histological analysis of skin wounds in rats. Forty Wistar rats were randomly assigned to four groups of 10 animals each: Control Group (CG), Laser Group (LG), Ozone Gas Group (OGG), and Ozonated Oil Group (OOG). Standardized skin wounds were created on the backs of the animals, and the experimental groups received their respective treatments for three consecutive days. Five and ten days post-surgery, five rats from each group were euthanized, and skin samples were collected from the wound area for histological processing. The samples were stained with hematoxylin-eosin and Sirius red. Five standard micrographs of each histological section were analyzed to assess granulation tissue cellularity, collagen organization, and vascular density. A significance level of p<0.05 was established for statistical analysis. On the 10th day after surgery, increased granulation tissue cellularity was observed in all groups except the OGG (p=0.043). A statistically significant difference in collagen organization was noted between the CG and LG on the 5th day (p=0.012). Vascular density was higher in the OOG than in the other experimental groups on the 5th and 10th days (p=0.045 and p=0.004, respectively). In gaseous form, ozone reduced chronic inflammation, while the oil form was particularly noted for its enhanced vascularization during both study periods. The photobiomodulated group demonstrated superior collagen organization.

 

##plugins.themes.default.displayStats.downloads##

##plugins.themes.default.displayStats.noStats##

Author Biographies

  • Flávia Quadros Lima, EBMSP

    Cirurgiã-dentista. Mestre em Medicina e Saúde Humana pela Escola Bahiana de Medicina e Saúde Pública.

  • Antônio Márcio Marchionni, EBMSP

    Cirurgião Bucomaxifacial. Doutor em Fotobiomodulação pela Universidade Federal da Bahia.

  • Beatriz Paim de Figueiredo Braitenbach, UFBA

    Nutricionista. Aluna de Mestrado do Programa de Pós-graduação Processos Interativos dos Órgãos e Sistemas.

  • Bruna Carvalho Lopez Moreno, EBMSP

    Graduação em Odontologia, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia.

  • Sarah Souza Lima, UFBA

    Bacharel em Saúde. Aluna de Doutorado do Programa de Pós-graduação Processos Interativos dos Órgãos e Sistemas.

  • Carla Barreto Cerqueira, UFBA

    Bacharel em Saúde. Fisioterapeuta. Aluna de Doutorado do Programa de Pós-graduação em Processos Interativos dos Órgãos e Sistemas.

References

1. Cerqueira CBS, Dantas JBL, Souza BGS, Carvalho MA, Medrado ARAP, Matos JBTL. Tissue repair under the influence of plasma jet and other biomodulator therapies - state of the art. Res Soc Dev. 2022;11(12):e470111234870. Available from: https://doi.org/10.33448/rsd-v11i12.34870. doi:10.33448/rsd-v11i12.34870. DOI: https://doi.org/10.33448/rsd-v11i12.34870

2. Özalp ÖA, Sindel MA, Altay IH, Özbudak B, Bilgin B, Kocabalkan B, et al. Comparative evaluation of the efficacy of ozone therapy and low level laser therapy on oral mucosal wound healing in rat experimental model. J Stomatol Oral Maxillofac Surg. 2022;123(6):e670-e674. Available from: https://doi.org/10.1016/j.jormas.2022.03.018. doi: 10.1016/j.jormas.2022.03.018. DOI: https://doi.org/10.1016/j.jormas.2022.03.018

3. Nesi-Reis V, Lera-Nonose DSSL, Oyama J, Silva-Lalucci MPP, Demarchi IG, Aristides SMA, et al. Contribution of photodynamic therapy in wound healing: A systematic review. Photodiagnosis Photodyn Ther. 2018;21:294-305. Available from: doi: 10.1016/j.pdpdt.2017.12.015. DOI: https://doi.org/10.1016/j.pdpdt.2017.12.015

4. Besser M, Schaeler L, Plattfaut I, Brill FHH, Kampe A, Geffken M, et al. Pulsed low-intensity laser treatment stimulates wound healing without enhancing biofilm development in vitro. J Photochem Photobiol B. 2022;233:112504. Available from: https://doi.org/10.1016/j.jphotobiol.2022.112504. doi: 10.1016/j.jphotobiol.2022.112504. DOI: https://doi.org/10.1016/j.jphotobiol.2022.112504

5. de Castro JR, da Silva Pereira F, Chen L, Arana-Chavez VE, Ballester RY, DiPietro LA. Improvement of full-thickness rat skin wounds by photobiomodulation therapy (PBMT): A dosimetric study. J Photochem Photobiol B. 2020;206:111850. Available from: https://doi.org/10.1016/j.jphotobiol.2020.111850. doi: 10.1016/j.jphotobiol.2020.111850. DOI: https://doi.org/10.1016/j.jphotobiol.2020.111850

6. Hänninen K. Contribution of excited ozone and oxygen molecules to the formation of the stratospheric ozone layer. Environ Ecol Res. 2019;7(3):121-134. Available from: https://www.hrpub.org/journals/article_info.php?aid=7920. doi: 10.13189/eer.2019.070302. DOI: https://doi.org/10.13189/eer.2019.070302

7. Smith NL, Wilson AL, Gandhi J, Vatsia S, Khan AS. Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility. Med Gas Res. 2017;7(3):212-219. Available from: https://doi.org/10.4103/2045-9912.215752. doi: 10.4103/2045-9912.215752. DOI: https://doi.org/10.4103/2045-9912.215752

8. Alan H, Vardi N, Özgür C, Hüseyin A, Yolcu Ü, Doğan DÖ. Comparison of the effects of low-level laser therapy and ozone therapy on bone healing. J Craniofac Surg. 2015;26(5):e396-e400. Available from: https://doi.org/10.1097/SCS.0000000000001871. doi: 10.1097/SCS.0000000000001871. DOI: https://doi.org/10.1097/SCS.0000000000001871

9. Kazancioglu HO, Ezirganli S, Aydin MS. Effects of laser and ozone therapies on bone healing in the calvarial defects. J Craniofac Surg. 2013;24(6):2141-2146. Available from: https://doi.org/10.1097/scs.0b013e3182a244ae. doi: 10.1097/SCS.0b013e3182a244ae. DOI: https://doi.org/10.1097/SCS.0b013e3182a244ae

10. Yucesoy T, Kutuk N, Canpolat DG, Alkan A. Comparison of ozone and photobiomodulation therapies on mental nerve injury in rats. J Oral Maxillofac Surg. 2017;75(11):2323-2332. Available from: https://doi.org/10.1016/j.joms.2017.04.016. doi: 10.1016/j.joms.2017.04.016. DOI: https://doi.org/10.1016/j.joms.2017.04.016

11. Yuca Y, Yucesoy T, Tok OE, Alkan A. The efficiency of ozone therapy and low-level laser therapy in rat facial nerve injury. J Craniomaxillofac Surg. 2020;48(3):308-314. Available from: https://doi.org/10.1016/j.jcms.2020.01.017. doi: 10.1016/j.jcms.2020.01.017. DOI: https://doi.org/10.1016/j.jcms.2020.01.017

12. Bayer S, Kazancioglu HO, Acar AH, Demirtas N, Kandas NO. Comparison of laser and ozone treatments on oral mucositis in an experimental model. Lasers Med Sci. 2017;32(3):673-677. Available from: https://doi.org/10.1007/s10103-017-2166-1. doi: 10.1007/s10103-017-2166-1. DOI: https://doi.org/10.1007/s10103-017-2166-1

13. Eckelman WC, Kilbourn MR, Joyal JL, Labiris R, Valliant JF. Justifying the number of animals for each experiment. Nucl Med Biol. 2007;34(3):229-232. Available from: https://doi.org/10.1016/j.nucmedbio.2007.01.005. doi: 10.1016/j.nucmedbio.2007.01.005 DOI: https://doi.org/10.1016/j.nucmedbio.2007.01.005

14. Scheibe PO. Number of samples — hypothesis testing. Nucl Med Biol. 2008;35(1):3-9. Available from: https://doi.org/10.1016/j.nucmedbio.2007.10.006. doi: 10.1016/j.nucmedbio.2007.10.006. DOI: https://doi.org/10.1016/j.nucmedbio.2007.10.006

15. Damy SB, Camargo RS, Chammas R, de Figueiredo LFP. Aspectos fundamentais da experimentação animal: aplicações em cirurgia experimental. Rev Assoc Med Bras. 2010;56(1):103-111. Available from: https://doi.org/10.1590/S0104-42302010000100024. doi:10.1590/S0104-42302010000100024. DOI: https://doi.org/10.1590/S0104-42302010000100024

16. Medrado AR, Pugliese LS, Reis SRA, Andrade ZA. Influence of low level laser therapy on wound healing and its biological action upon myofibroblasts. Lasers Surg Med. 2003;32(3):239-244. Available from: https://doi.org/10.1002/lsm.10126. doi: 10.1002/lsm.10126. DOI: https://doi.org/10.1002/lsm.10126

17. Braitenbach BPF, Cerqueira CBS, Lima SS, Hegouet IC, Moreno BCL, Medrado ARAP. Effects of photobiomodulation on adipocytic infiltration in sites of skin healing: in vivo experimental study. Lasers Med Sci. 2025;40(1):153. Available from: https://doi.org/10.1007/s10103-025-04410-1. doi: 10.1007/s10103-025-04410-1. DOI: https://doi.org/10.1007/s10103-025-04410-1

18. Alvarenga MOP, Bittencourt LO, Mendes PFS, Ribeiro JT, Lameira OA, Monteiro MC, et al. Safety and effectiveness of copaiba oleoresin (C. reticulata Ducke) on inflammation and tissue repair of oral wounds in rats. Int J Mol Sci. 2020;21(10):3568. Available from: https://doi.org/10.3390/ijms21103568. doi: 10.3390/ijms21103568. DOI: https://doi.org/10.3390/ijms21103568

19. Cañedo-Dorantes L, Cañedo-Ayala M. Skin Acute Wound Healing: A Comprehensive Review. Biomed Res Int. 2019;2019:3708260. Available from: https://doi.org/10.1155/2019/3706315. doi: 10.1155/2019/3706315. DOI: https://doi.org/10.1155/2019/3706315

20. Sampaio LAS, Costa JS, Freire TFC, Reis SRA, Deiró TCBJ, Medrado ARAP. Influence of protein malnutrition on cutaneous wound healing in rats. Rev Nutr. 2018;31(5):433-442. Available from: https://doi.org/10.1590/1678-98652018000500001. doi:10.1590/1678-98652018000500001. DOI: https://doi.org/10.1590/1678-98652018000500001

21. Fortuna T, Gonzalez AC, Sá MF, Andrade ZA, Reis SRA, Medrado ARAP. Effect of 670 nm laser photobiomodulation on vascular density and fibroplasia in late stages of tissue repair. Int Wound J. 2018;15(2):274-282. Available from: https://doi.org/10.1111/iwj.12861. doi: 10.1111/iwj.12861. DOI: https://doi.org/10.1111/iwj.12861

22. Hegouet IC, Lima SS, Medrado ARAP. Efeitos da ozonioterapia sobre as fibras colágenas e elásticas no reparo cutâneo: um estudo histomorfométrico em ratos. Rev Ciênc Méd Biol. 2024;23(2):242-248. Available from: https://doi.org/10.9771/cmbio.v23i2.64117. doi: 10.9771/cmbio.v23i2.64117. DOI: https://doi.org/10.9771/cmbio.v23i2.64117

23. Pourhashemi E, Amini A, Ahmadi H, Ahrabi B, Mostafavinia A, Omidi H, et al. Photobiomodulation and conditioned medium of adipose-derived stem cells for enhancing wound healing in rats with diabetes: an investigation on the proliferation phase. Lasers Med Sci. 2024;39(1):46. Available from: https://doi.org/10.1007/s10103-024-03974-8. doi: 10.1007/s10103-024-03974-8 DOI: https://doi.org/10.1007/s10103-024-03974-8

24. Mostafavinia A, Amini A, Sajadi E, Ahmadi H, Rezaei F, Ghoreishi SK, et al. Photobiomodulation therapy was more effective than photobiomodulation plus arginine on accelerating wound healing in an animal model of delayed healing wound. Lasers Med Sci. 2022;37(1):403-415. Available from: https://doi.org/10.1007/s10103-021-03271-8. doi: 10.1007/s10103-021-03271-8 DOI: https://doi.org/10.1007/s10103-021-03271-8

25. Kim HS, Noh SU, Han YW, Kim KM, Kang H, Kim HO, et al. Therapeutic effects of topical application of ozone on acute cutaneous wound healing. J Korean Med Sci. 2009;24(3):368-374. Available from: https://doi.org/10.3346/jkms.2009.24.3.368. doi: 10.3346/jkms.2009.24.3.368. DOI: https://doi.org/10.3346/jkms.2009.24.3.368

26. Pchepiorka R, Moreira MS, Lascane NADS, Catalani LH, Allegrini S Jr, de Lima NB, et al. Effect of ozone therapy on wound healing in the buccal mucosa of rats. Arch Oral Biol. 2020;119:104889. Available from: https://doi.org/10.1016/j.archoralbio.2020.104889. doi: 10.1016/j.archoralbio.2020.104889. DOI: https://doi.org/10.1016/j.archoralbio.2020.104889

27. Cardoso JM, Ervolino E, Miyasawa EM, Theodoro LH, Padovan LEM, Pereira EL, et al. Unveiling the therapeutic potential of systemic ozone on skin wound repair: clinical, histological, and immunohistochemical study in rats. Biomed Res Int. 2024;2024:6623114. Available from: https://doi.org/10.1155/2024/6623114. doi: 10.1155/2024/6623114. DOI: https://doi.org/10.1155/2024/6623114

28. Soares CD, Morais TML, Araújo RMFG, Meyer PF, Oliveira EAF, Silva RMV, et al. Effects of subcutaneous injection of ozone during wound healing in rats. Growth Factors. 2019;37(1-2):95-103. Available from: https://doi.org/10.1080/08977194.2019.1643339. doi: 10.1080/08977194.2019.1643339. DOI: https://doi.org/10.1080/08977194.2019.1643339

29. Acikan I, Sayeste E, Bozoglan A, Artas G, Isayev A, Kirtay M, et al. Evaluation of the effects of topical application of chlorhexidine, ozone, and metronidazole on palatal wound healing: a histopathological study. J Craniofac Surg. 2022;33(6):1929-1933. Available from: https://doi.org/10.1097/scs.0000000000008390. doi: 10.1097/SCS.0000000000008390. DOI: https://doi.org/10.1097/SCS.0000000000008390

30. Xiao W, Tang H, Wu M, Liao Y, Li K, Li L, et al. Ozone oil promotes wound healing by increasing the migration of fibroblasts via PI3K/Akt/mTOR signaling pathway. Biosci Rep. 2017;37(6):BSR20170658. Available from: https://doi.org/10.1042/bsr20170658. doi: 10.1042/BSR20170658. DOI: https://doi.org/10.1042/BSR20170658

31. Sathwik M, Komarraju S, Sathyanath D, Muralidharan S. Technical considerations of ozonated oils in medical applications: a narrative review. Cureus. 2025;17(4):e83185. Available from: https://doi.org/10.7759/cureus.83185. doi: 10.7759/cureus.83185 DOI: https://doi.org/10.7759/cureus.83185

32. Rafiei Y, Ghamsari SM, Sasani F, Ezzaty A, Golchin D, Akbari AM, et al. Evaluation of the healing effects of different methods of using ozone in third-degree skin burns in the rat experimental model. Iran J Vet Surg. 2025;20(1):47-54. Available from: https://doi.org/10.30500/ivsa.2024.453505.1402. doi: 10.30500/ivsa.2024.453505.1402.

33. Liu L, Zeng L, Gao L, Zeng J, Lu J. Ozone therapy for skin diseases: cellular and molecular mechanisms. Int Wound J. 2023;20(6):2376-2385. Available from: https://doi.org/10.1111/iwj.14060. doi: 10.1111/iwj.14060. DOI: https://doi.org/10.1111/iwj.14060

34. Krkl C, Yiğit MV, Özercan İH, Aygen E, Gültürk B, Artaş G. The effect of ozonated olive oil on neovascularization in an experimental skin flap model. Adv Skin Wound Care. 2016;29(7):322-327. Available from: https://doi.org/10.1097/01.asw.0000484172.04260.46. doi: 10.1097/01.ASW.0000484172.04260.46. DOI: https://doi.org/10.1097/01.ASW.0000484172.04260.46

35. Zhu M, Cao L, Melino S, Candi E, Wang Y, Shao C, et al. Orchestration of mesenchymal stem/stromal cells and inflammation during wound healing. Stem Cells Transl Med. 2023;12(9):576-587. Available from: https://doi.org/10.1093/stcltm/szad043. doi: 10.1093/stcltm/szad043. DOI: https://doi.org/10.1093/stcltm/szad043

36. Veith AP, Henderson K, Spencer A, Sligar AD, Baker AB. Therapeutic strategies for enhancing angiogenesis in wound healing. Adv Drug Deliv Rev. 2019;146:97-125. Available from: https://doi.org/10.1016/j.addr.2018.09.010. doi: 10.1016/j.addr.2018.09.010. DOI: https://doi.org/10.1016/j.addr.2018.09.010

37. Castro TNS, Martignago CCS, Assis L, de Alexandria FED, Rocha JCT, Parizotto NA, et al. Effects of photobiomodulation therapy in the integration of skin graft in rats. Lasers Med Sci. 2020;35(4):939-947. Available from: https://doi.org/10.1007/s10103-019-02909-y. doi: 10.1007/s10103-019-02909-y. DOI: https://doi.org/10.1007/s10103-019-02909-y

38. de Oliveira LP, Chagas AL, de Souza TR, Araújo IR, de Menezes LB, Miguel MP, et al. Low-power laser in increasing doses improve wound healing process in rats. Lasers Med Sci. 2023;38(1):60. Available from: https://doi.org/10.1007/s10103-023-03716-2. doi: 10.1007/s10103-023-03716-2. DOI: https://doi.org/10.1007/s10103-023-03716-2

39. Andrade TOS, Dantas BL, Cerqueira CBS, Badaró P, Marchionni AMT, Medrado ARAP. Comparative study of the effectiveness of ozone therapy and laser photobiomodulation upon experimental wound repair: systematic review. Res Soc Dev. 2022;11(5):e58911528650. Available from: https://doi.org/10.33448/rsd-v11i5.28650. doi: 10.33448/rsd-v11i5.28650. DOI: https://doi.org/10.33448/rsd-v11i5.28650

40. Waasdorp M, Krom BP, Bikker FJ, van Zuijlen PPM, Niessen FB, Gibbs S. The bigger picture: why oral mucosa heals better than skin. Biomolecules. 2021;11(8):1165. Available from: https://doi.org/10.3390/biom11081165. doi: 10.3390/biom11081165. DOI: https://doi.org/10.3390/biom11081165

41. Moreira SH, Pazzini JM, Álvarez JLG, Cassino PC, Bustamante CC, Bernardes FJL, et al. Evaluation of angiogenesis, inflammation, and healing on irradiated skin graft with low-level laser therapy in rats (Rattus norvegicus albinus Wistar). Lasers Med Sci. 2020;35(5):1103-1109. Available from: https://doi.org/10.1007/s10103-019-02917-y. doi: 10.1007/s10103-019-02917-y. DOI: https://doi.org/10.1007/s10103-019-02917-y

42. Calisto FC, Calisto SL, Souza AP, França CM, Ferreira AP, Moreira MB. Use of low-power laser to assist the healing of traumatic wounds in rats. Acta Cir Bras. 2015;30(3):204-208. Available from: https://doi.org/10.1590/s0102-865020150030000007. doi:10.1590/S0102-865020150030000007. DOI: https://doi.org/10.1590/S0102-865020150030000007

43. Hidayat AT, Arifin MT, Nur M, Muniroh M, Susilaningsih N. Ozonated Aloevera oil effectively increased the number of fibroblasts and collagen thickening in the healing response of full-thickness skin defects. Int J Inflam. 2021;2021:6654343. Available from: https://doi.org/10.1155/2021/6654343. doi: 10.1155/2021/6654343. DOI: https://doi.org/10.1155/2021/6654343

Published

26/02/2026

How to Cite

Quadros Lima, F., Marchionni, A. M. ., Paim de Figueiredo Braitenbach, B. ., Carvalho Lopez Moreno, B. ., Souza Lima, S. ., Barreto Cerqueira, C. ., & Medrado, A. R. A. P. (2026). HISTOLOGICAL EVALUATION OF SKIN WOUNDS IN RATS SUBJECTED TO PHOTOBIOMODULATION AND OZONE THERAPY. RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218, 7(3), e737325. https://doi.org/10.47820/recima21.v7i3.7325