Effect of Ozone Therapy (OT) on Healing of Colonic Anastomosis in a Rat Model of Peritonitis.

Colonic resection and anastomosis is one of the most common operations in gastrointestinal surgery, both in children and adults. Although these are safe operations, an anastomosis leakage is a frequent problem (1, 2). Age, condition of the patient, colonic flora, inflammation and surgical techniques are the most important factors affecting the outcome of these procedures (3, 4). The presence of peritonitis is a defining factor of anastomosis integrity. The cecal ligation and puncture (CLP) model was first defined by Hubbard et al. (5) in 1978 to induce peritonitis. Several studies suggest that in the presence of peritonitis, wound healing worsens and anastomotic leakage increases. To avoid these unwanted effects of peritonitis on wound healing and to increase anastomosis security, various methods and local or systemic agents are being investigated. Ozone is a three-oxygen molecule (O3). Ozone therapy (OT) is systematically effective when pathological inflammatory and immunologic processes are activated. Among these conditions are wound healing, macular degeneration related to aging, and conditions that are ischemic or infectious. During OT, the gaseous mixture of oxygen and ozone exerts biological actions that may increase certain enzymes and cytokines. Ozone provides its protective effects via autacoids, cytokines, and growth factors. Recurrent OT corrects the disturbed redox equilibrium by affecting the antioxidant system (6–10). Positive effects of OT on caustic oesophagus injuries have also been suggested (11). The concept of using ozone to accelerate the healing of infected wounds, necrotic or low oxygenated tissue has been explored in orthopaedics, dentistry and skin wounds. The use of these therapeutics in the healing of colonic anastomosis was explored for the first time by Lelyanov et al. (12). The aim of the present study was to determine the effects of OT on anastomotic healing in a rat peritonitis model.