Ozone therapy in oral mucositis in post-hematopoietic stem cell transplantation patients: an intervention study with assistive technology production

Oral mucositis (OM) is a key complication of chemotherapy and radiotherapy in Hematopoietic Stem Cell Transplantation (HSCT), besides being a very frequent stomatological event. It directly influences the quality of life of patients. The applicability of ozone-therapy is a hypothesis to be scientifically tested for the prevention and treatment of OM of these patients, owing to the fact that it is a powerful oxidizing agent, as well as it triggers oxidative reactions, impacting bactericidal actions, fungicides, modulating oxidative stress and the immune system. The objectives were to verify the efficacy of ozone therapy for the management of oral mucositis, as a complementary therapy to conventional treatment, in post-transplanted hematopoietic stem cell patients; as well as to produce a protocol for the use of ozonized water as a mouthwash by health professionals. Regarding the method, this is a Randomized Clinical Intervention Study conducted with patients over seven years of age, submitted to HSCT and, diagnosed with OM, hospitalized in the Bone Marrow Transplantation Service of the Hospital das Clinicas Complex, Federal University of Paraná, Curitiba. The simple randomization technique was used, with the participants allocated in the Control Group (CG; n=8) or Intervention Group (IG; n=9); in GI, they were submitted to oral washing with Water for Injection (WI) ozonized at 9.94 Mig/ml, twice a day, added to the routine protocol of the service. As results, Grade III and IV were observed in the CG, while Grade II was predominant in IG, with p<0.05 from day D+6 to D+11. The pain score was p = 0.05 in D+11; with p <0.05 between D+6 and D+11. The average difference in the duration of hospitalization was 7.3 days lower for the IG. In the face of the positive results achieved with the research Protocol, a care technology was developed in the modality of a protocol, denomination of Ozonized Water as Mouthwash: Protocol for the use of ozone by health professionals, applied to the health service being researched. As conclusions, a statistically significant difference was made between the IG and CG regarding the severity of OM, pain scores and the reduction of hospitalization days for patients submitted to HSCT. Thus, the efficacy of ozonized WI in the management of OM in patients after HSCT is demonstrated, by confirming the alternative hypothesis that complementary therapy with the O2/O3 mixture can contribute to attenuate symptomatology, such as the reduction of pain and severity scores of the lesion, therefore favoring faster patients' recovery when compared to the control group. To support the safety and quality of this practice, in order to be applied in other scenarios, a care protocol was developed and registered in the Brazilian Book Chamber.